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f/7eE1'CTYOF � /NSTRUCTION � ������� <br />everett PERMIT PERMIT NO.OH636 <br />CITY HALL 259�8745 <br />EVERETT,WA 98201 ❑ COMBINATION ❑ BtqLDING �icMECHANICAL ❑ PLUM1A4ING <br />01YNER MFILAODRE55 QiY ZIP PHONE <br />Abner M. Wagner 5029 Crest Lane 98203 252-8128 <br />ARGHITECT OR DESIGNER MAIL AU�RE55 CITV ZIP FHONE <br />GENEPALCONit�ACiOR MAILADpRESS CITY ZIP PHCNE UGENSEI <br />Same <br />MECNANICAL CANTRACTOfl MAII ADDNE55 CITY ZIP PHONE LICENSE / <br />PWMFiINGCANTRACTON MALLAODRE55 CITY ZIP PHONE UCENSE� <br />❑NEW ❑ADDITION ❑ALiEFAT10N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />E <br />DESCRIBE WORK <br />Fireplace insert <br />PROPOSED USE OF BUILDING <br />LEGAL OESCRIPTION OF PqOPERiV �SNOW BELOW OR <br />l07 BLOC�OF <br />JOB AOOFE55 <br />5029�Crest Lane <br />PLUMBINO <br />N0. TYPE OF FI%TURE OR <br />WATER CLOSET (TOILET� <br />BATHTUB <br />LAVATORY ryJASH OASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASNER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER NEATEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR. EfC ) <br />SUB TOTAL <br />PEHMIT <br />TOTALFEE <br />SIDE YARD SETBACK STREET SE78ACK <br />USE ZONE <br />TYPE OF C( <br />SI2E OF BL <br />FIRE ZONE <br />LOT AFEA <br />GN] <br />BASEMENT <br />1. ENVIPONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTALIMPACTSTATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY PIANS CHECKED BV <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AIJD ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OT'1ER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR i'�E PERFORMANCE OF CONSTRUCTION. <br />SIGNATUjiE ONTRA ROFAUt ORI DAGENT OAiE <br />X �i%i^���� 12�1�80 <br />MECHANICAL <br />NO. TYPE OF EQUIPMF <br />AIR COND UNITS — H.P. EA. <br />fi[fRIGERATION UNIT$ — H,P. EA <br />�OILERS — N.P. EA. <br />GAS FIRED A.Q UNITS — TONYA( <br />FORCFD AIR SVSTEMS — 6 T ll. <br />REAR YARD SETBACK IPLAN <br />OYES ❑NO <br />NO. OF DWELLING UNITS <br />APPR.PORISSUANCE DY <br />WALL NEATERS — 8 T.U. <br />UNIT HEATERS — B.LU. <br />EVAPORATIVE COOLERS <br />VENTIIATION FAN <br />AIR HANDLING UNIT — <br />METAL FIREPLACE 8 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTV � <br />TOTAL <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />PLAN <br />FEE <br />VALUATION <br />S <br />U B.C. <br />SEC. 303 (a) <br />RECEIPT NO. <br />FEE <br />7 <br />WHEN PROPERLY VALIUATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />�cc,� �007.50—c�► <br />� <br />. � ;. r:_c�,:IPT o <br />� .. .. � �� �I �,' U <br />