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��' ' C�'JNSTRUCTION � . <br /> everett PERMIT PI:RMITNQ:= � ��8� <br /> 259-8745 - <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDIN6 X�l MECHANICAL ❑ PLUMlING ❑ sIGN <br /> ONTlER M�IL�ODRE55 CITY ZIP VHONE <br /> PETER VAN DALEN 8807 Emerson Place Everett WA 98204 353-2811 <br /> 11RCHITEC�dIDE51GNER MAILADORE55 pITY (IP PFqNE <br /> OENEMLCONTMCTOB M�IL�pORE55 CITY ZIF fMONE UCENSE♦ <br /> Same <br /> MEpUNICAL CONTRACTOR M�IL ROORE55 CITY ZIP �HONE UCENSE� <br /> iLUAAAING CONTA�CTOR MAII ADDRESS CITV 21P ;NONE UCENSE t <br /> :XAS$Of WqiK <br /> ❑ NEW ❑ ADDiT10N ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDIN6 RELCCATON <br /> VAIU�TION OF WORK <br /> S <br /> DESCRIBE WORN <br /> Install woodstove <br /> HE�TSOURCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHf:S <br /> PROPOSEO USE OFlUILDING <br /> Residence I HEREBY CERfIFY THAT I HAVE READ AND EXAMINEO THIS <br /> APPLICATIUN AND KNOW THE SAME TO BE TRUE AND <br /> LEp�LDESCRIFIIONOFPRpPERTY�SHOWBEIOWONATTACNFOURCOVIES� CORRECT. P.IL PROVISIONS OF LAWS AND ORDINANCES <br /> ior__e�oc� _ or GOVERNI�IG THIS TYPE OF WORK WILL HE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DUES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE �q LOCAL LAW REGULATING CONSTRUCTION OR <br /> TF;E-PF ORMANCE OF CONSTRUCTION. <br /> !Od�DORESS SIG�UTUtiF.O LO RA . U RRED PGENT.OR ONNER DATE <br /> 8807 Emerson Place X �� 10 29 6 <br /> PLUMBING MECiiANICAI <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO, TYPE OF EOUIPMENT FEE <br /> WATER ClOSET(TOILET) A/C—A/HNDLG UNITS—HP. <br /> BATHTUB REFRIGERATION UNITS—H P.[A. <br /> LAVATORV(WASH BASIN) BOILERS—B.T.U./H.P. <br /> SHOWER GAS fIflED AC.UNITS—B.T-.U. <br /> KITCHEN SINK 8 OISP. FORCED AIF SYSTEMS—B.T.U. M EA. <br /> DISHWASI/ER WALLHEAiERS—BS.U. M <br /> LAUNDRYTRAY UNITHEAiERS—B.T.U. M <br /> CLOTHES WASHEii EVAPOHATIVE COOLERS <br /> UFINAL CLOTMEJ DRVERS iQ�'��BG 3:5 O�NZT� ��� <br /> DRINKING FOUNTAIN VENTILATION FAN � <br /> FLOOR DRAIN RANGE HOOD <br /> BACKFLOW PREVENTERS WATER HEATER • s�, <br /> ROOFDRAINS—RAINLEADERS � WOODSTOVE (� q�� <br /> SINK(SERVICE—BAR,ETC.) IdETAL FIREPLACE 8 CHIMNEY <br /> FIREPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING <br /> �XHAl15T FAN <br /> SUBTOTAL S SUB70TAL <br /> PERMIT f PERMIT <br /> TOTAL FEE f TOTAL FEE <br /> iRONT SETBACK REAR 6ETBACK SIOE SETDACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> USE 20NE LOT�REA yqCANT SITE <br /> ❑YES ❑r+o FF_ES VALUATION FEE <br /> TYPEOFCONSi. OCCUPRNCYGROUP NO.OFOWELLINGUNITS BUILDING S <br /> PLUMBING <br /> SIZE OF BLDG NO.OF STORIES Mn% OCG LOAO <br /> MECHANICA� <br /> INVESTIGATION Ft:E Sec.304(c) <br /> FIRE SPRINNLERS REOUIRED VES NO <br /> STATE:BUILDING SURCHARGE <br /> STATEENERGVSURCHARGE <br /> AA'LI�ATION ACC.BY PLRNS CHECNEO DY APPtl FOR ISSUANLE OY <br /> DRIVEWAY PERMIT <br /> TOTAL <br /> PERMIT VALIDATION <br /> WHEN PRUPEFLV VALIDA'fED(IN THIS SPACE)TMIS IS VOUR PERMIT <br /> N' <br /> � <br /> r� <br /> ti <br /> � <br /> ao���i-ss � �.,� <br />