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the Evergreen INSTRUCTION <br />CITY OF <br />everett PERMIT PERMIT No. 21164 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING $] MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />William Feris 306 Madison St. Everett, WA 98203 347-2710 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE II <br />Valley Natural Gas 2605 McDougal Everett, WA 98201 259-5492 VALLENG153LI <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE• <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION 8:ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />DESCRIEE WORK <br />Install forced air system and water heater <br />HEATSOUICE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS -YPE OF W `RK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNA RE OF CONTRACTOR. ORIZ GENT• OR OWNER DATE <br />X 11/1/88 <br />LEGAL DESCRIPTION Or PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK. _ OF <br />JOB ADDRESS <br />306 Madison St. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - A/HNOLG UNITS - H.P. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY ( WASH BASIN) <br />BOILERS - B.T.U./H.P. <br />SHOWER <br />GAS FIRED ABC. UNITS - B.T.U. <br />KITCHEN SINK B DISP. <br />1 <br />FORCED AIR SYSTEMS —B.T.UI0O MEA. <br />9 <br />00 <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRYTPAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />1 <br />WATER HEATER <br />6 <br />50 <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />_ <br />X <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />S <br />SUB TOTAL <br />15 <br />50 <br />PERMIT <br />$ <br />PERMIT <br />15 <br />00 <br />TOTALFEE <br />$ <br />TOTAL FEE $ <br />3C <br />50 <br />FRONT SETBACK <br />REARSETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />11/01/BB 3:+1PM <br />/ <br />RECEIPT NO <br />000A43210 fl <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑NO <br />FEES <br />�44DDD�'[IOAT <br />FEE <br />BUILDING <br />5 MECH $ <br />7.00 <br />_— <br />TYPE OFCONST. <br />OCCUPANCYGROUP <br />NO. OF DWELLING UNITS <br />PLUMBING <br />t <br />HECH $30.50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />MECHANICAL <br />CHECK $ <br />7.50 30 <br />50 <br />FIRE SPRINKLERS REQUIRED YES ONO <br />INVESTIGATION FEE <br />Sec. 304(e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />M.M. <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />301.50 <br />ecuut,r vel mennu <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />4 <br />ADDRESS FILE <br />