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`�'a!�vi',l'k"`w..'a:: <br /> tHe£rc�veoF � �O[VSTRUCTIO(� ��� � <br /> eyerett PERMIT pERMIT NO. 09725 <br /> CITY HALL 259�8745 <br /> EVERETT.WA 9B20t ❑ COMBINATION ❑ BUILDING X� MECHANICAL ❑ pLUMBING <br /> OWNEP M!•�ADOPE55 CITY ZiP PHONE <br /> TOM LOWERY 5624 COMNERCIAL Everett 98203 353-2018 <br /> ARCHITEC70RDESIGNER MAILAODPE55 CITV ZIP PMONE <br /> GENERFLCONiRACiOR MAILADOPE55 CITV ZIP PNONE LIGENSE/ <br /> Owner <br /> MECMRNICALCANTRACTOF MAILAUDRE55 CITV ZIV PMONE LICENSE! <br /> PlVM41NGGONTRAQ�n: MAII ADDRES$ CITV ZIP PNONE LICENSE I <br /> CLASS OF WORN <br /> RXNEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI710N ❑FENCE ❑SIGN OGARAGE <br /> VALUATION OF WORH <br /> 5 <br /> OESCRIBE WORK <br /> Install wood stove <br /> PPOPJSED USE OF BWLDING <br /> Resi dence I HEREBY CERTIF� THAT I HAVE READ AND EXAMINED THIS AP- <br /> IfGALD[SCRIPTIONOFPROPEFiV�SHOW OEIOWORATTACHFOUFCAPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND CRDINANCES GOVERNING THIS <br /> �_oT s�ocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NO1. TH[ GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHGRITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE F�RFORMANCE OF CONSTRUCTION. <br /> JOB AUDRESS SIGNHT� CANT1iACTOR OR A THORiZED AGENT DATE <br /> 5624 Cortmercial X 8 31 81 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. � PE OF E IPMENT FEE <br /> WATER CLJSET(TOILEf) AIR CJND.UNITS—H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA <br /> LAVATORY(WASH BASIN) BOILERS—H P.EA. <br /> SHOWCR GAS FIflED A.C.UNITS—TONNAGE EA. <br /> KITCNEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.LL M EA. <br /> DISHWASHEfl WALL HEATERS—B T.U. M <br /> LAUNDRY TRAV 11N1T HEATERS—B T.U. M <br /> CLOiHES WASHER EVAPORATNE COOLERS <br /> \NATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE&CHIMNEY f3� <br /> SINK ISERVICE—BAH,EfG) _ <br /> SUB TOTAL SUBTOTAL S <br /> PERMIT S PEflMIT S <br /> TOTALFEE f TOTALFEE S <br /> SIDE YARD SETBACK STRLET SET�ACK REAR YARD SETBACK PLAN CHECK NUM9ER PWN CHECK FEE <br /> FEE RECEIP7 NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> L]YES ❑NO FEES VALUATION fEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNIiS � <br /> BUILDING <br /> 512E OF BLOG. NO.OF STORIES MAX.OCC.LOAD <br /> aLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKL[RS <br /> REOUIRED MECHANICAL �G 5O <br /> ❑VES ClNO <br /> APP�70VALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK IIST PENALTV U B.C. <br /> 2. BUILDING PLANS SEC.3031a) <br /> 3, FIRE HYDRANT T�TA� �4 5O <br /> 4. FIRE PROTEC710N SYSTEM PEHMIT VALIDATION <br /> VJHEN PROPERLY VALIDATED(IN THIS SPACE)7HIS IS YOUR PERMIT <br /> 5. GRADING <br /> l.f'� <br /> 6. DRAINAGE . � ' I I. C �'' _� � <br /> 7. ENVIRONMENTALIMPACTSTATEMENT � � ' � ' �' ' <br /> 0. HEALTH DISTRICT � <br /> � <br /> APPLICATION ACC.BY PLAHS CHECKED BY APPR.FOR ISSUANCE BY • <br /> : i <br />