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"i <br /> tltr ErrrAreen <br /> everett � �� NSTRUCTIO �� <br /> PERMIT PERMIT NO. 15 �� `� <br /> CITV HALL 259�87d5 <br /> � EVERETT.YJA9ffi01 ❑ COMBINATION ❑ BUILDING �'1 MECHANICAL ❑ PLUMBING <br /> OWNEF MAILADDRE55 �ITY ZIP PNONE <br /> R ,70RGFN DAH7 4n9A rr.,Ennamn avFanr. cvoar.c m ppA_98203 ZiP 258=9.1-7-7 <br /> ARCHiTECi OP DESIGNE9 MAIL AODRE55 PHONE <br /> G[NERaL CONTRqCTOR MAII AODRE55 pITY 21P PryONE UCENSE M <br /> $��' <br /> MECHANIGAL CONTRACTOR MAIL ADDRESS CITV 2iP PMONE LIL[NSE Y <br /> PlUM61NG CONTRRGTOR N41L A�DRE55 CITY ZIP PHONE LICENSE M <br /> GLA55 OF WORe <br /> ❑NEW � ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FEMCE ❑ SIGN Q WOOD STOVEIFIREPLACE INSERT <br /> VqLUATION OF WORK <br /> f <br /> DESCRIBE WORK <br /> Install free standing stove <br /> PROPOSEO USE OF PUIL�ING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS o <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND .�. <br /> LEGALDESGRIPTIONOFPROPERTY�SMOWBELOWORATTACMFOURCOPIES) CORRECT. ALL PROVISIONS OF IAWS AND ORDINANCES � <br /> LOT_BLOCN_OF GOVERNING THIS TYPE OF WORK WILL E3E COMPLIED WITH m <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING Of A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE ,� -'",� <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR � � <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE �n x <br /> PERFORMANCE OF CONSTRUCTION. �" <br /> JOB RD�RE55 SIGNATURE OF CONi f,TOH Op AUiHORIZEO AGFNT DATE C O <br /> 4928 Glenwood Avenue X 12/17/85 m c�i <br /> PLUMBING MECHANIC O 3 <br /> m <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE s � <br /> m <br /> WATER CLOSET�TOILEn AIR COND. UNITS-- H.P. EA. <br /> BATHTUB '� Z <br /> REfRIGERATION UNITS- H.P. EA. G <br /> LAVA70qY(WASH BASIN� BOILERS - H.P. EA. fa- x <br /> �r �-. <br /> _ SHOWER GAS FIRED A.C.UNI7S- TONNAGE EA. -� N <br /> t <br /> _ KITCHEN SINK 8 DISP. FOFCED AIR SVSTEMS- B.T.U. M EA. 'T7 <br /> �ISHNIASHER WALL HEATERS- B.T.U. M � A <br /> LAUNORV TRAV UNIT HEATEFiS- B.T.U. M --I �T31 <br /> CLOTHES WASHER EVAPORATIVE COOLERS f=Tl �-+ <br /> WATER HEA7ER CLOTHES DRYERS O N <br /> URINAL VENTILAiION FAN � m <br /> ORINKING FOUNTAIN RANGE HOOD 3 N <br /> FLOOR DRAIN �� <br /> AIR HANDLING UNIT - �,F,M, 2 f� <br /> VACUUM BREAKERS j STOVE-WOOD � n <br /> ROOF DRAINS- RAINLEAOERS METAL FIREPLACE 8 CHIMNEY 70 <br /> SINK�SERVICE - BAR,C'C.) FIREPLACEINSERT � <br /> 2 <br /> HEAT PUMP D <br /> z <br /> --1 <br /> S <br /> N <br /> SUB 70TAL S SUB TOTAL S � <br /> PERMIT S PEHMIT 5 --I <br /> TO7ALFEE f iOTAL FEE 5 n <br /> m <br /> � SIDE YARD SETBACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZC�YE LOT AREA VACAN7 SIiE _ <br /> :_:YES ��. �.NO FEES VAIUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLiNG UNITS <br /> BUILDING 5 <br /> 5¢E OP BLDG. NO.OF STORIES MA%.OCC. LOAD <br /> PLUMBING <br /> FIRE 20NE DASEMENT FII7E SPRINKLEFS - <br /> REOUIRED MECHANICAL 17 SO <br /> YES NO <br /> APPROVALS BV DATE OTHEF <br /> 1.E�IVIRONMENTAL CHECK LIST U.B.C. <br /> PENAITY SEC.30J lal <br /> 2.�UI�OING PLANS <br /> 3.FIRE HYDRANT TOTAL <br /> a.FIRE PROTECTION SYSTEM PEHM�T VALIDATION <br /> 6.DRA NIAGE �NHEN PROPERLY VALIDA'ED pN THI�5� J F,J THIS�y,OyRp�M1T_`;� <br /> 5 UII � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT �b-' <br /> B.HEALTH DIS7qICT , , . , ,� . �' �- i � � <br /> .!�l <br /> � <br /> APPLICATION ACC. BY PLANS CHECKED BV APPR.FOR ISSUANCE BY � � '� '" � <br /> �'.. � � � <br /> � � �, ..�� . � <br /> ADDRECS FIL[ <br />