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��� t''�NSTRUCTION - . <br /> CITY OF <br /> everett pERMIT F�ERMITNQ:-� �J� u <br /> 259 -8745 <br /> C3�DEMOLITIOh ❑ COMBINA71011 ❑ BUILDING ❑ MECHANICAL ❑ pLUMBING ❑ SIGN <br /> ONTvER MAIL D CITY ZIP PHONE <br /> Bethany Home 3322 Broadway �'v���tt, WA 98201 8frax8 259-5508 <br /> ARCHITECTOq0E5tGNER MAILAOOFESS CITY ZIP PHONE <br /> GENER4L CONTRACTOR MNL qODRESS CITY <br /> ZIP PMONE LICENSEx <br /> owner <br /> MECNqNIChLCONTRFCTOR MAILA�pRESS CITY ZIP PNONE LICENSE• <br /> PLUMBING CONTRAC'tOR MAIL AOOqE55 CITY ZIP PHONE LICENSE� <br /> CLASS OF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR L�F DEMQLITION ❑ BUILDING RELOCATInN � <br /> VALURTION OF WOPN I <br /> S � <br /> OESf.qIBE WORK _ I <br /> Demolish & remove house on property <br /> HEATSOURCE <br /> ❑ EL[CTqICITY ❑ GAS ❑ WOODSTOVE ❑ OTHEH <br /> PROPOSED USE OF�UILOING <br /> Sinal.e family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGr1LUE5CRIPTIONOFPROPERTV � APPLICATION AND KNOW THE SAME 70 BE TRIIE AND <br /> (.,HOWOELOWOBATTACHFOURCOPIES) CORRECT. ALL PROVISIONS OF LAWS AND OROMANCES <br /> ioi 13 BLOCK79S oF Everett Land Co. lst Add, GOVERNING THIS TYPE OF WORK WILL BE COA!�LIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRF NTING OF A <br /> PERMIT DUES NOT PR[SU�AE TO GIVE AUIHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL L�W R GULATING CONSTF`UCTION OR <br /> THE PERF RMAN�F C NSTRUCTION. � <br /> JO�AD�RESS TUR 0 ONT LT AU � f:i2EDAGENT,OqCWNEA OATE <br /> 3325 Lombard Ave X 3/17/87 i <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTltRE OR ITEM FEE k0. TYPE OF EOUIPMENT FEE I <br /> WATER CLOSET(TOILET� A/C—A/HN�L3 UNITS—H P. <br /> BATHTUB REFPIGERATION UNITS—HP.EA, <br /> LAVATORY(WAgH BAS W) 601LER5—P T.U./H P. <br /> SMOWER GAS FIHED A:.UNITS—B.T.U. <br /> NITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNDRV7qAY UNITHEATERS—�.T.U. M <br /> CLOTHES.VASHER EVAPOI7ATIVE COOLERS <br /> URINAL CLOTHESDRVERS <br /> DRINNING iOUNTAIN VeNTILATION FAN <br /> FLOOR�RAIN RANGE HOOD <br /> BACKFLOW PqEVENTERS WATER HEATER • <br /> ROOF DHAINS—RAINLEADERS WOOD STOVE <br /> SINK(GERVICE—BAR,ETC.) METAI FIREPL4CE 8 CMIMNEV <br /> FIREPLACE INSEfi? <br /> HEAT PUMP <br /> GA$PIPING <br /> E%HAUSTFAN <br /> 1 <br /> _ i <br /> SUBTOTAL f SUBTOTAL I <br /> PERMIT <br /> S PEPMIT <br /> TOTALFEE S TOTALFEE I <br /> FPONT SETBACN REAR SETBACN sioe seiencrc P�AN CHECK NUMBER FCE RECEIPT NQ � <br /> ' <br /> USEZONE �pTAqEp � <br /> VACANT SITE �— <br /> ❑res ❑No FEeS VALUATION FEE <br /> TYPEOFCONST OCCUPANCYGROUP NOOFOWELLiNGUNtTS BUILDING S —I)� <br /> PLUM�ING <br /> SIZE OF BLDG N0.OF STOPIES h1AX.OCC.LOAO <br /> MECHANICAL <br /> n ! {::j <br /> INV[STIGATION FEE � Sec.3p4(e) . <br /> FIRE SPRINKLEFS REOUIRED ❑VES ❑NO NOOOl YL <br /> STdTE 6UILDING SURCHARGE 1 SO <br /> _ � ` <br /> STATEENEFGVSURCHARGE {{00O�6OSS <br /> APPLICATION ACC DY VLANS CnECNED DY qPPp FOR ISSUANCE F3V <br /> DRIVEWAYPERMIT � '-• � <br /> � � <br /> M.D1, TOTAL E•�p� 1,5� 1 50 <br /> PEFlMIT VAlIOATION {iQUI�:''bU�7'b <br /> WHEN PROPERLV VALIOATED(IN TNIS.S?ACE)THISlS�Y@l1H PERMIT <br /> �.f�jFi C��.C� Q.� <br /> t� <br /> �� <br /> �� <br /> r� <br /> l:iIUHESS FILE <br />