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the ErerAreen <br /> �,T��F �- -rONSTRUCTIOf�' - <br /> everett PERI� I'T PERMIT N0. 13L15 <br /> CITY HALL 2i9�B745 <br /> EVERETf,WA 98201 [� COMBINATION ❑ BUILDING � MECHAIVICAL ❑ PLUMBING <br /> OWNER MAILADDRE55 CITY T.IP PHONE <br /> DOU� PORTER 7 MAGNaLIA FUFRFTT WA 9R70i aa�_�aaF <br /> FRCMREGi OF OESIGNEN MAIL ApOFE35 GITY ZIP PHONE <br /> GENERfLWNiRACTOR MAILApDRE55 CITY ZIP PHONE LILENSEx <br /> MECHPNICAL GOYT�IAGTOR MFIL AOCSESS CITY ZIP PMONE LICENSE x <br /> PLUMBING CONTRAGTOfl MAIL ADDRE55 CITY ZIP PNONE �ICENSE� <br /> ClA55OF WJHK <br /> ❑NEW O ADDITION ❑ ALTLflATION ❑REPAIF ❑ DEMOLITION ❑ FENCE ❑ SIGN � WOOD STOVE/FIREPLACE INSERT <br /> VALUAT101:OF WORK <br /> S <br /> DESCRIBE WORK <br /> Install wood stove <br /> PROPOSEO VSE OF 9UIL�ING � <br /> Resi dence I HEREBY CERTIFY THP.T I HAVE READ AtJD EXAMIIJcD THIS <br /> APPLICATION AND KMOW THE SAME TO BE TRUE AND n <br /> LEGAl�ESCFIVTIONOFPflOPER�Y�SMOWBELOWORATTAGHFOURGOPIES) CORRECT. ALL PROVIliIONS OF LAWS AND ORD�NANCES �t� <br /> LOT_BLOCK__OF GOVERNING THIS TYP;_OF WORK WILL Bc COMPLIED WITH " <br /> WHETHER SPECIFIEU NEREIN OR NOT.THE GRANTING OF A <br /> i�ERMIT DCES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVIS�ONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTI�N OR THE H H <br /> PE ORMANCF CONSTRUI'�TION. y K1 <br /> JOB 0 PE55 SIG PE OF CONT G! R OR AUTHOR12EL FGENT DATE H � <br /> � �iagnolia X �— 4 10 84 �' <br /> PLUMBING MECHANICAL R� <br /> NO. TYPE OF FIXTURE Ofl ITEM FEE N0. TYPE OF EOUIPMENT FEE y � <br /> WATER CLOSET(TOILEn AIR COND. UNIiS— H.P.EA. � <br /> BATHTUB REFRIGC-RATION UNITS— H.P.EA. <br /> LAVATORY(WASH BASIN� BOILERS— H.P.EA. H <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. � zy <br /> KI'�:HEN SINK 8�ISP. FORCED AIR SYSTEMS— B.T.U. M EA. � x <br /> DISHWASHER WALL HEATERS— B.T.U. A1 � ~ <br /> N <br /> LAUNDRYTRAV UNIT HEATERE— B.T.II. M O � <br /> CLOTHES WASHER EVAPORATIVE COOLERS hy <br /> WFTER HEATEF CLOTHES DRYERS <br /> 11flINAL VENTILATION FAN _ � � <br /> L`IINKING FOUNTAIN RANGE MOOD �+ <br /> FLOOR DRAIN AIH HANOLING UNIT— C.F.M. F*] <br /> VACUUM BREAKERE STOVE—WOOD �Un1 <br /> ROOF ORAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY (rr) <br /> SRJK(SERVICE— BAR,ETC.) FIREPLACE INSERT • � <br /> HEAT PUMP <br /> — � <br /> SU9TOTAL S SUB70TAL f � <br /> H <br /> PENMIT S PENMIT f � p1 <br /> TOTAL FFE 5 TO7AL FEE S � <br /> SIDE VARD SETOACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PL4N CHECK FEE <br /> FEE FECEIPT NO. (~j <br /> USE ZONE LOT AREA YACANT SITE �T� <br /> C�.YES ;:NO FEES VqLUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILOING S <br /> SIZE OF BLDG. NO.OF STORIES MA':.OCC.lOAD <br /> PLUMBING <br /> FIRE ZONE 6ASEMENT FIRE Si�HINKLERS ��ECHANICAL �� 5O <br /> REOUIRcU <br /> '. ��.YES :- NO <br /> APPflOVAlS BY OATE OTHER <br /> 1.ENVIRONMENTAL CHECK UST PENALTY U.B.C. <br /> 2.BUILDING PLANS SEC.303(a) <br /> J.fIREHVORANT T�TA� �] 5Q <br /> 4.FIREPFlOTECTION SYSTEM PENMIT VALIOAiION <br /> 5.GRAOING WHEN PROPERLY VALIDAI'ED(W THIS S�i CE�THIS Iy.V0Ly7 iEF�M� _�„O� <br /> 11 J � � ) <br /> 6.DRAINAGE <br /> 7.E4VIRONMENTALIMPACTSTATEMENT __I M <br /> B.HEALT'rIDISTRICT , ;, -�� �_'pT . <br /> 4PPUCATION ACC.BV PLANS CHECKED BY APPR.FOP ISSUANCE BV ' � ' ' � " " � �-� <br /> �. _ : . 7 �.. �� <br /> I <br /> i � I'.i i G'i <br /> ADDRESS FIL[ <br />