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. .-� � <br /> _ — 1 , <br /> . � <br /> `�"��`�T�`�° '- �ONSTRUCT�ON" ti <br /> everett PERII� �T PERMIT NO. 12�40 � <br /> � GTY HALL 259�87d5 <br /> EVERETT,WA90201 � COMBINATION ❑ BUILDING C�: MECHANICAL ❑ PLUMBING <br /> � <br /> OWNEP MRILADDNE55 GITY Z�i` PMONE I <br /> Eric VanDuren 8802 Dmerson Place Bverett 98204 247-3915 ' <br /> RRCMREGT OR DESIGNEN MRIL AOORE55 GITY 21P VHONE � <br /> GENERAL CONiN�CTOF MAIL ADDRESS CITY ZIP PHONE LICENSE� <br /> MEGHANICAI CONTRPCTOR MAIL R��PESS QTY 2�P PMONE LICEIAE� <br /> Same <br /> PLUMBING CONTRRCTON MRIL RODRE55 GITY ZIP PMONE LIGENSE� <br /> . GlA55OF WORK � <br /> �lEW ❑ hD01T10N ❑ ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVEIFIREPLACE INSE�' <br /> WLWTION OF WORR <br /> s <br /> DESGRIBE WORI( <br /> install wo�d stove �I <br /> PROP05ED USE OF BUILOING ( <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND I <br /> LEGRLDESGRIPTIONOFPROPERtY15NOWBELOWORATfAC11F0UflCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BIOGK_OF GOVERNING THIS TYPE OF JJORK WILL BE COMPLIED WITH � <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOCS NOT PRESUME TO GiVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHEP, STATE OR <br /> LOCAL LAW RF:GULATING CONSTRUCTION QR THE <br /> PERrORMANCE CONSTFUCTIOM. <br /> JOB ADDRE55 SIGNFTUPE OF C�[!iP C R 0 HOPIZED RGEN7 1Z�27�g3 <br /> 8802 IInerson Place X � � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET�TOILEn AIR COND.UNITS— H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORV�WASHBASIN� BOILERS— H.P.EA. <br /> SHOWER GAS FIRED A.C.UNIiS—TONNAGE cA. <br /> KITCMEN SINK 3 DISP. FOflCED AIR SVS"EMS— B.T.U. M EA. <br /> UISHWASHER WALL HEATERS— B.T.U. M . <br /> LAUNORYTRAY UNIT MEATEPS— B.T.U. M <br /> CLOTMES WASHER EVAPORA i IVE COOLERS � <br /> V/ATER MEALER CLOTMES DRYERS <br /> UriINAL VENTILATION FAN <br /> DPINKING FOUNTAIN RANGE HOOD I <br /> FLOOR DRAIN Alfl HANDLING UNIT— QF,M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLAC:8 CMIMNEY <br /> SIKK(SERVICE—BAR,ETC.) FIREPLACE INSEdT <br /> HEAT PUMP ( <br /> SUB 70TAL S SUB TOTAL f 7 50 <br /> PERMIT f PEPMIT S (� <br /> TOTAL FEE f TOTAL FEE f 1� SO <br /> SIDE YARD SETBACK STREET SETBACK REAli YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE flECE1PT NO. <br /> USE ZONE LOT AREA �ACANT SITE FEES VALUATION FEE � <br /> CYES ::NO — <br /> TYPE OF WNS. OCLUPANCY GROUP NO.OF D1':ELLING UNITS <br /> BWLDING S ( <br /> SIZE OF BLDG, NO.OF SiORIES MA%.OCQ LOAD 4 <br /> PLUMBING � <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL 1� SO <br /> REOUIRED 1 <br /> :.YES CNO � � <br /> APPPOVALS BY DATE OTHER � <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.30�(a) <br /> 2.BUILOINGPLANS TOTp� 1'] SO <br /> 3.FIRE MYDRANT � <br /> 1.FIRE PPOTECTION SYSTEM PERMIT VALIDRTION <br /> S.GRADING WMEN PROPERLY VALIDATED(IN TM��PpC�)TMISdIS�I'�Uf}P��iIT � <br /> � � JU � �) � <br /> � 6.DRAINAGE � /� I <br /> 7.ENVIRONMENTAL IMPhCT STATEMENT . ('�j � <br /> B.HEALTHDISTRICT "�>U r^. RECEIPT � �� � <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY ' <br /> Da i i ;F�i`:� YOU <br /> 23 �:c fis <br /> ADDRESS F1'_[ <br /> � <br /> '_ ..� <br />