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�heE°�TYo° , C-�7NSTRUCTION �- .�� <br /> everett PERMIT pERM1T NO. OH454 <br /> CITY HALL 259�8745 <br /> EVERETT,WA 98201 ❑ COMBINATION �c BUILDING ❑ MECIiANICAL ❑ PLUMBING <br /> UWN[R MFILAD�PE55 CIIY ZIP PMONE <br /> William L. Welch 8923 Emerson Place 98204 355-7748 <br /> ARCIUTECTOROESIGNER MAILAODRL55 CITY 21P PHONE <br /> GENERAL CONiRAGiOR MAIL AD�PESS CITY 21P PMONE IICENSE I <br /> Same <br /> MFCHANICALCANTRACTOR MAILAODRESS CITY ZIP PHONE LICENSEI <br /> PLUMBING CANTRRG70R MAIL AO�f�ESS CITY 21P PHONE LICENSE/ <br /> CLASS OF WORK <br /> ❑NEW ❑AUDITION ❑ACiERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> b <br /> DESLNIBE WORN <br /> install free standing wood stove <br /> PROPOSED USE OF BUtLDING '� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LWALOESCRIPTIONOFPROPERTY�SIIOIYBELOWORATTACMFOURCOPIES� � PLI�ATIOW AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALt�ROVISIONS Of IAWS AIJD ORDINANCES GOVER�ING THIS <br /> �or BLOCK�OF IYPE OF WORK WILI. BE COMPLIED WITH WHETHER SPECIFIED <br /> HERFIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNAiURE OF COtRRACTOR OR AUtHOPI EO AGEN DAiE <br /> �oo nooaess 10/2 0/8 0 <br /> 8923 Emerson Place X ' — � <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSEi QOILET) AIF7 COND.UNITS—N.P.EA. <br /> BATHTUB fiEFRIGERATION UNITS—H.P.EA <br /> I,AVATORY(WASH BASIN) BOILERS—H P.EA. <br /> SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITCHEN SIIJK 8 DISP. FORCED AIR SYSiEA15—B.T.U. M EA. <br /> DISHWASHER WALI HEAT[RS—�S.U. M <br /> LAUNDRY TRAY UNIT IIEATERS—8 T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WAtER HEATER CLOTHFS ORYERS <br /> URINAL V[NTILATION FAN <br /> �� DRINKING FOUNTAIN RAN(iE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F,M. <br /> VACUUM BREAKERS STOVE � <br /> � ROOF CRAMS—RAW�EADERS METhL FIREPLACE 8 CHIMNEV <br /> � SINK(:ERVICE—BAR,ETC.) — <br /> SUB TOTAL _ SUB TOTAL S � <br /> PERMIT f PERMIT S 3 00 <br /> r TOTALFEE f TOTALFEE S � <br /> �� SIDE YARD SETBACK STREET SETBACK F�E4R YARD SETE3ACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE F7ECEIP7 NO. � <br /> USE ZONE LO7 AREA VACANT SI7E FEES VALUATION FEE <br /> y ❑VES ❑NO — <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> i <br /> OUILDING $ <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> I FIRB ZONE BASEMENi REOUIRED KLERS MECHANICAL 7 5 O <br /> �VES ❑NO <br /> APPROVALS BY DATE OTHER <br /> t. ENVIRONMENTAL CHECK UST PENALTY U B.C. <br /> SEC.303(a) <br /> 2. BUILDING PLANS _ TOTAL 7 S O <br /> 3. FIRE HYDRANT _ <br /> d, FIRE PROTECTIUN SYSTEM PERMIT VALIDATION <br /> WHEN PPOPERLY VAl�DATED QN 7HI5 SPACE)THI515 YOU11?ERMIT <br /> 5. GRADING 9 3 I 1 $ O O �. � 0 —� <br /> 6. DRAINAGE � <br /> 7. ENVIRONMENTALIMPACTSTA7EMENT �^ � <br /> B. HEALTH DISTRICT � ' �� �� !� P-C L I PT Q <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY . �,�'..���r K Y C� U <br /> V. C . <br />