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„��. �,����e�F �_ - CONST�UCTIQ ' � <br /> e�er�tt p��� �T PERMITNO. � 55�n <br /> CITY HALL£59�8745 <br /> EVERETT,WA 90201 � COMBINATION ❑ BUILDING X�1( MECHANICAL ❑ PLUMBING <br /> UWNER MFILADDRE55 CITY 21P PHONE + <br /> MARLENE SMITH 2110 LOMBARD EVERETT lJA 252-2814 <br /> ARCMITECT OR OESIGNER MAIL APORESS CITY ZIP PHONE <br /> GENEF/+L CONTRACTOR MAI�ApORE55 CITY 21P PNOVE LICENSE� <br /> Same <br /> MECHANICAL GONTRACTOR MAIL ApDRE55 CITV ZIP PMONE LICENSE M <br /> PLUM9ING C�NTRACTOR MAIL F�ORF'.5 CITY ZIP PHONE LICENSE M <br /> CLASS OF WORK <br /> ❑ NEW ❑ ADDI110N ❑ ALTERATION ❑REPAIR ❑ OEMOLITION ❑ FENCE ❑ SIGN � VJOOD STOVEIFIREPLACE INSERT <br /> VALUATION OF WOAK <br /> S <br /> OESCRIBE WORN <br /> Install woodstove <br /> PROPOSED 5 OF BUILDING <br /> Resi�ence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION .4ND KNOW THE SAME TO BE TRUE AND n <br /> LEGAL DESCRIPTION OF PROPERTY(SHOW BE�OW OF ATTFCM FOUR CO�IES� CORRECT. ALL PROVISIONS OF LAVJS AND ORDINANCES � <br /> �or_eiocK_ov_ GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF?, <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> � OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CON:tTRUCTION OR THE H H <br /> PERFORMANCE OF CONSTRUCTION. �,�� I�LI � "3 'n <br /> JOD 5 SIGNATIIFE OF CONTPACTOR OR AUTH 9GE A Ni ” OAT�E"' p.� <br /> `��� Lombard X /� � 10/15/85 �' � <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE � <br /> l/ATERCLOSET�TOILET) AIR COND. UNITS �— M.P.EA. � <br /> BATHTUB REFRIGERATION UNITS — H.P.EA. <br /> LAVATOR�'(WA."iH BASIN) BOILERS — H.P. EA. p z <br /> SHOWER GAS�IHED A.C. UNITS—TONNAGE EA. y <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. H � <br /> DISHWASHER WALL HEATERS— B.T.U. M '"�' � <br /> LAUNDHY TRAY UNIT HEATERS— B.T.U. M � � <br /> CLOTHES WASHER EVAPORATIVE COOLERS � <br /> WATER HEATER CLOTHES DRVERS � <br /> URINAL VENTILATION FAN ~ <br /> _ N <br /> CRINKING FOUNTAIN RANGE HOOD � <br /> FLOOR DRAIN AIR HANDLING UNIT— QF.M. <br /> VACUUM BREAKERS STOVE—WOOD N <br /> RJOF�RAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY � SO � <br /> SINK(SERVICE— BAR, ETG.) FIREPLACE INSERT � <br /> HEAT PUMP <br /> . � <br /> SUB TOTAL a SUB TOTAL S O H <br /> PERMIT S PERMIT S O OO � <br /> TOTALFEE S TOTAL FEE f O C7�� <br /> SIDE YARD SEiBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMOER PLAN CM.ECK FEE F' <br /> FEE RECEIPT NO. � <br /> USE ZONE LOT AREA VACANT SITE <br /> ::YES . .NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> OUILDING E <br /> SIZE OF BLDG. NO.OF STORIES h1AX.OCC. LOAD <br /> PLUMBING <br /> FIREZONE BASEMENT pE0U5RED KLERS MECHANICAL �] 5O <br /> VES ; .NO <br /> APPROVALS BY DATE �THER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTV U.B.C. <br /> SEC.303(a) <br /> 2.BUILOING PLANS — — <br /> 3.FIREHVDRANT T�TA� �� 5D <br /> 4.FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> 5.GRADING H'HEN PROPERLV VAUDATE��IN THIS SPACE)THIS IS VOUR PEHMIT �'��� <br /> 6.DPAINAGE <br /> h119 $ � � �. 50 — .:� <br /> 7.ENVIRONMENTALIMPACTSTATEMENT -^ <br /> :: l <br /> B.HEALTH DISTRICT T � <br /> APPLICA710N ACC.BV PLANS CHECKED 9V APPR. FOR ISSUANCE BY ` ' � U I�� I:�l.F I I�i � � <br /> - i .1n.�v��� ��L� � <br /> I > LCi �) <br /> l�DDRGSS fIL[ � <br />