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theL•���ergrcen �pNSTRUCTlOP' - ,� <br /> GTY OF <br /> ev�rett PERI�IT pERMIT N�. OH962 <br /> CITYIiALL259�8745 � COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING <br /> EVERETT.WA 98201 <br /> MAIL A��RESS <br /> CITV ZIP PMONE <br /> OWNEA <br /> Terry ����� 1007 Lombard Everett <br /> lAAi�ADDF�E55 <br /> CITY ZIP PIIONE <br /> ARCHRECT OR DESIGNEF <br /> GENERALCONiFFGTOR <br /> IAPILADDRE55 CITY ZIP PHONE LICZN]EA <br /> Same Terrx Collins PHONE uceNs=_r <br /> MECHANICFLGONiRACTOF <br /> M4ILNDORE55 CITV Z�P <br /> MAILADDf�E55 CITV ZIP PHONE LICEIISEN <br /> PWMBING <br /> ClAS50F WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REFAIR ❑DEM�LITION ❑FENCE ❑SIGN GARAG: <br /> VALUATION OF WORK <br /> S <br /> DESCRIBE WORK <br /> instal wood stove <br /> F90POSED USE OF�UILOMG <br /> I HEREBY CERTIFY THAT I HAVF REf,D AND EXAMINED TNIS � <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> �ecn�oescaianor+oF Peoaean isNow oe�ow oR nrracn Founcoaies� ALL PROVISIONS CF LAWS AND ORDiNANCES GOVERNING THIS <br /> ipT BLOCI(�_OF TYPE OF WORK WILL BE COMPLIED 4VITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING CF A PEFMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGN `OF Cf PA t' UiHOR17ED AGENi �ATE <br /> J00 ADDRE55 � 3�S I8 1 <br /> 1007 Lombard <br /> MECHANICAL <br /> PLUMBING FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT <br /> AIR COND.UNITS—H.R EA. <br /> NJATER CLOSET(TOILET) <br /> REFRIGERA110N UNITS—H.P.EA <br /> pATHTUB <br /> �OILEHS—H.P.EA. <br /> lAVA10HY(WASH BASIN) <br /> G45 FIRED A.C. UNITS—TONNAGE EA. <br /> SHOwER ' FORCED AIR SYSTEldS—�.T.U. M EA. <br /> K�TCHEN SINK d DISP. M <br /> N'ALL HEATERS—B T.U. <br /> DISIIWASHER M <br /> UNIT HEATERS—B.T.U. <br /> LAUNDRY TRAY <br /> EVAPORATNECOOLERS <br /> fLOTHES WASHER — CLOTHES ORYERS <br /> WATER HEATER <br /> VENTILATION FAN <br /> URItJAL RANGE HOOD <br /> DRIPIKING FOUNTAIN C.F.M. _ <br /> �IR HAND.ING UNIT— <br /> ROOR ORAIN 1 STOVE <br /> VACWM BREAKERS <br /> METAL FIREPLACE 8 CHIMNEY <br /> ROOF DFiAINS—RAINLEADERS <br /> SINK�SERVICE—BAP.ETCJ <br /> SUB TOTAL 5 4 S O <br /> SUB TOTAL pEflMIT $ <br /> PEHMIT S S <br /> — TOTALFEE S TOTALFEE <br /> PLAN CHECK PEE <br /> SIDE YAflG SETBACK STREET SETBACR REAR YARD SETBACK FLAN CHECK NUMBER FCE RECEIPT NO. <br /> USE ZONE LOT AREA VACAN7 SITE FEES VALUATION FEE <br /> lJYES ❑NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELUNG UNITS <br /> BUILDING $ <br /> SIZE OF ALDG. NO.OF STORIES h1AX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT RE�UIRED KLERS MECHANICAL 'I S O <br /> ❑YES ❑NO <br /> ' BY DATE OTHER <br /> APPHOVAIS <br /> UBC. <br /> 1. ENVIRONMEN'.AL CHECK LIST PENALP' SEC.303(a) <br /> 2. BUILDING PLANS iOTAL 7 S 0 <br /> 3. FIRE HYDRANT <br /> PEPMIT VALIDATION �.. 7 O i . � J O --(\J'V <br /> A. FIRE PROTECTION SYSTEM __ WHEN PROPERLY VALIDATED(W THIS SPCCE)THIS IS�G,�1F�P- MIi <br /> I� IJ <br /> 5. GRADING <br /> � <br /> 6. ��7AINAGE � <br /> 7. ENVIRONMENTAL IMPACT STATEMENT • ' l "''� �' '`�i <br /> . . : .. .1„ ii � <br /> 8. HEALTH DISTHICT ,.� . I� <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR.FOR ISSUANCE BY _ !.. � '�- <br /> V.C. <br /> '_..�.-- - � ,' ,it o I <br /> =� . , <br /> ADDRESS FILE <br /> � . <br /> � <br />