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� ��° r''�JNSTRUCTION <br /> evErett PERMIT PERMITNQ:-� U�03 <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMHINATION ❑ BUILDING � MECHANICAL ❑ PLUMBINCa ❑ SIGN <br /> OWNEH MAIIADDRE55 CITV ZIP PHONE <br /> Lynn Corder 6512 Elliott Way Everett 98203 339-3450/348-4711 <br /> ARCHITFCT OR OESIGNER MAIL ADORE55 CITY ZIP PHONE <br /> GENEflr1L CONTRACTOq MAIL AOpqESS CITY ZIP PHONE LICENSE� <br /> MECNRNICAL CONTRRCTOR MAI�ADDRESS CITV Z�P PMONE �ICENSE• <br /> PLUMBINGCONTRACTOR MFILADDRESS dTY 21P PHONE ULENSE� <br /> CLASS OF WOHK <br /> ❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VALWTION OF WORN <br /> f <br /> DESCRIBE WORK <br /> Installation of wood stove <br /> MEATSOURCE � <br /> ❑ ELECTRICITY ❑ GAS ❑ WOOIlSTOVE ❑ OTHER <br /> PROPOSED USE OF C UILpING <br /> Single family residence I HEqEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGALOESCRIPTIONOFfROPERiY�SHOWBE�OWOfiPTTACNFOIIRCOPIES) APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> 7 Division 00 Plat of Beverl CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BIOCK _. OF Y GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A <br /> H11� E1/Z Of �Ot 8 VOIUrtI� 10 page �8 PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PHOVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRES3 SIG RE OF CONTRACTOR,AUTHORRE�AGENT,OR OWNER DATE <br /> G512 Elliott Way X —7_�_ <br /> PLUMBING MECHA CAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT �E <br /> WATER CLOSET(TOILET� A/C—A/HNDLG UNITS—H.P. <br /> DATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS— �� <br /> O.T.U./H.P. <br /> SHO WER GAS FIRED A.C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED Alq SYSTEMS—BS.U. M EA. <br /> DISHWASFIER WALL HEATERS—B T.U. M <br /> LAUNDRYTRAY UNITHEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> URINAL CLOTHES ORYE(75 <br /> DFINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BACKFLOW PflEVENTERS WATER HEATER • <br /> ROOF ORnINS—RAINLEADERS 1 WOOD STOVE 3O O <br /> SINK(SERVICE—BAR,ETC.) METAL FIREPLACE 8 CHIMNEV <br /> PIqEPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUB TOTAL f SUB TOTAL 30 00 <br /> _ PERMIT f PE � <br /> i• Xt# <br /> TOTAL FEE S TOTAL FEE 3O OO <br /> FflONT SET6ACK REAR SETDACK SiOE 58roqCK PLAN CHECK NUMBEH F�16� qECEIPT NO. <br /> USE20NE LOTAREA <br /> f1ECH .00 <br /> VACANTSITE FEES ATION FEE <br /> ❑YES ❑NO <br /> TYPEOFCONST OCCUPANLYGFDUP NOOFOWELLINGUNITS BUILDING S <br /> PLUMBING <br /> 512E OF BL�G NO OF SiOPiES MR% OCG LOAD <br /> MECMANICAL 3O OO <br /> INVESTIGATION FF.E Sec.304(e) <br /> FIRESPRINKLERSREOUIRED OVES NO <br /> STA7E BUILDING SURCHARGE <br /> STATEENERGVSURCNARGE <br /> AVPLICATION ACC DY PLANS CHECNEO DY qPPP iOR ISSUANCE 0Y <br /> DRIVEWAY PERMIT <br /> TOTAL 30 00 <br /> PEflMIT VALIOATION <br /> WHEN PROPERIV VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> M <br /> O <br /> O7 <br /> CD <br /> � <br /> i:1,� .0 5 f�.; <br /> I <br />