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iheEr�RYeoF -- (�-�7NSTRUCTION -� .-� <br /> everett PERMIT PERMIT NO. OH4S4 <br /> CITY HALL 257 97C° <br /> EVERETi,WA 98201 ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILAODRE55 CITY Z�P M�aNE <br /> William L. Welch 8923 Emerson Place 98204 355-7748 <br /> ARCMITEGT OR DESIGNER MAIL ADDRE55 CITV ZIP PHONE <br /> GEN[RALCONTRACTOfl MAILADDRE55 CITY ZIP �HONE IICENSEf <br /> Same <br /> MECNANICAL CONTRACTON MAIL AODRESS QTY 21P PHONE LICENSE I <br /> PLUM�ING:ONTRACTOII MAIL ADpR[SS GIiV ZIP PNONE LICENSE I <br /> CLA55 OF 1YORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> b <br /> OESCPIBE WORK <br /> install free standing wood stove <br /> PROPoSEO USE OF BUILDING ' <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> U�GALDESCPIPTIONOFPROPEATY�SNOWBELOWORATTAGIIFOURWPtE5) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior BLOCK__OF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREItJ 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 /> SIGNAiU�E OF CANiHACiOR OP AUiMORI_E�AGEN DnTE <br /> JOB ADDRESS <br /> 8923 Emerson Place X � 10/20/80 <br /> PLUMBINfi MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR CCND.UNITS—H.P. EA. <br /> BA7MTU� R[PRIGERATION UNITS—H.R EA <br /> LAVA70RY(WASH BAEM) �OILERi—H.R EA. <br /> SHOWER GAS FIRED A C.UNIiS—TONNAGE EA. <br /> KITCHEN SINK 8 JISP. FORCED AIR SVSTEMS—B T.U. M EA. _ <br /> DISHWASHER 1NALL H6ITEPS—B.T.U. M <br /> LAUNDRY TRAV UNIT HEAiERS—B.T.U. M <br /> CLOTHES\YASHER EVAPORATIVE COOLERS <br /> WATER HEAiER CLOTHES DRYERS <br /> URINAL V[N11LAilON FAN <br /> DRINKING FOUNTAIN RANGE HOG� <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS � j STOVE <br /> ROOF�RAINS—RAINLEADERS METAL FIREPIACE 8 CHIMNEY <br /> SINK(SERVICE—BAR.ETC.) <br /> � <br /> � <br /> SUBTOTAL SUBTOTAL S �+ <br /> PERMIT S PERMIT S 3 00 I <br /> TOTALFEF S TOTALFEE S � <br /> SIDE YARD SETBP.^!! STREET SET�ACK REAq VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACAN7 SITE I <br /> ❑VES ❑NO FEES VALUATION FEE <br /> ( <br /> 7YPE OF CANST. OCCUPANCV GRUUP NO.OF DWELIING UNI75 <br /> BUILDING S � <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS � <br /> REOUIRED MECHANICAL 7 5 0 <br /> ❑YES ❑NO <br /> APPROVALS BY DATE OTHER � <br /> 1. ENVIRONMENTAL CHECK LIST pENALN U.B.C. <br /> 2. BUILDING PLANS SEC.303(a) <br /> 3. FIRE HYORANT TOTAL � 7 5 O <br /> 4. FIRE PROTECTION SYSTEM PERMIT VALIDATION � <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS�YOUR PERMIT <br /> 5. GRA�ING 9 3 I 7 „A Q O �. � O --� <br /> fi. DRAINAGE � <br /> 7. ENVIRONMENTAL IMPA;T ST.Q[MENT p � I <br /> B. HEALTH DISiRICT � � �� �: 1��C t_I PT� I <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE DY • r n '. t�� li�' U � <br /> �n <br /> V,C. <br /> 7 Q UCT $� <br /> ADDRESS FILE � <br /> ,I <br /> I <br />