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l,rt' Lt't.rAr�.�.,t -� O N ST R U CT I O I� � <br /> everett � � <br /> PERMIT PERMIT N0. 15379 <br /> CITY HALL 259�8745 <br /> EVERETT,WA907.01 ❑ COMBINATION ❑ BUILDING C�}XMECHANICAL ❑ PLUMBING <br /> OYlNER MAILAD�RES$ CITY ZIP PHONE <br /> Deborah I Ray 2001 Lombard Everett 98201 252-5951 <br /> AflCHREGT OR OESIGNEF MAIL A�DflE55 GTY 21P PHONE <br /> GENERAL CONTRALTOfl MAII A�DRE55 CITY 21P PHONE LICENSE N <br /> MECHANICAL CONTRPCTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N <br /> Same <br /> PLUMBING CONfRAGTOR MAIL AOOFE55 CITY ZIP PMONE LICENSE M <br /> CLASS OF WORK <br /> O NEW ❑ ADDITION O ALTERA710N �REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN (�?{WOpD STOVFJFIREPLACE INSERT <br /> VALUATION OF WORK — <br /> E <br /> DESCRIBE WORK <br /> Install wood burning stove <br /> PFOPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIPTIONGFPROPERTY�SHOWBELOWORATTACHFOUFCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VVITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADORESS 51 FE OF CONTRACTOfl OR UT RI GENT ppTG <br /> 2001 Lombard X j � � � 9/4/85 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT —� fEE <br /> WATERCLOSE7(TOILEn AIR COND. UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P. EA. <br /> LAVATORY�WASH BASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIF[D A.C. UNITS —TONNAGE EA. <br /> KI7CHEN SIIJK 8 DISP. FORCED AIR SYSTEMS — 9.T.U. M EA. <br /> DISHWASHER WALL HEA7ERS— R T.U. M <br /> LAUNORY TRAY L'LIIT HEATERS— BS.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WA7ER HEATER CLO7HES DRVERS <br /> URINAL VENTILATION FAN <br /> ORINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— FAINLEADERS METAL FIREPLAC[& CHIMNEV <br /> SINK(SERJICE — BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE 5 70TAL FEE 5 17 50 <br /> SIDE YARD SETBACK STREE7 SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE PECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> f:YES �-:NO PEES VALUATION FEE <br /> TYPE OF CONST. OCCU�ANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING $ <br /> SIZE OF BLDG. NO.OF S70RIES MAX.OCC. LOAD <br /> PLUM8ING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOU�RED 17 SO <br /> �.:YES I_�.NO <br /> APPHOVALS BY UATE OTHER <br /> 1. EAV!RGNMENTAL CHECK LIST U.B.C. <br /> PENALTY SEC.303(a) <br /> 2.BUILOING PLANS <br /> 3.FIREHYDRANT 70TAL 17 SO <br /> 4.FIRE PRO�ECTION SYSTEM PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN TF1�S�17�9E)THI�ISIYDUii REqM17 � <br /> 6.DRAINAGE U I ! J V <br /> 7.EAVIRONMEN7ALIMPACiSTATEMENT M <br /> 8.HEALTH DISTFiICT Yo u r� �c c E i��r � <br /> APPLICATION ACG BY PLANS CHECKED BY APPR.FOR ISSUANCE BY <br /> 1 i-!f',i!�; YO U <br /> - l4 SEP $5 <br /> ADDRESS FILE <br />