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the I-Aw��' <br />�NSTRI� II.# N <br />evexett <br />PERMIT <br />17038 <br />PERMIT NO. <br />259-8745 <br />r] DEMOLITION <br />❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING <br />❑ SIGN <br />OYMER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Larry L. Dunning <br />2109 Hoyt Ave Everett, WA 98201 <br />256-2083 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSED <br />Owner <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE II <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE <br />❑ NEW C ADDITION ❑ ALTERATION ® REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK , <br />S 450.00 <br />DESCRIBE WORK <br />Replace rotten framing, flooring, etc. insulate <br />HEAT SCURCE <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 TYPE OF WORK, 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 />SIGNATURE OF CONTRACTOR. AUTHORIZED AGENT, OR OWNER DATE <br />x E/18/86 <br />LEGAL DESCH IPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPI ES) <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />2109 Hoyt Ave <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — A/HNDLG UNITS — H R <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — B.T.U./H.P. <br />SHOWER <br />GAS FIRED A.C. UNITS — B.T.U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRS"RAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />URINAL <br />CLOTHES DRYERS <br />_ <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTEHS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.) <br />METAL FIREPLACES CHIMNEY <br />FIREPLACE INSERT <br />_ <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />$ <br />SUBTOTAL <br />PERMIT <br />$ <br />PERMIT <br />TOTALFEE <br />$ <br />TOTALFEE <br />FRONT SETBACK <br />REARBETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$450.00 <br />15 <br />OO <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />H 36 <br />444 <br />SIZE OF BLDG <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />MECHANICAL <br />H000170M <br />FIRE SPRINKLERS REQUIRED OYES ONO <br />INVESTIGATION FEE. <br />304(e) <br />STATE BUILDING SURCHARGE <br />fio"5M5 <br />1 <br />50 <br />STATE ENERGY SURCHARGE <br />EL±'� <br />APPLICATION ACC BY <br />Di.t1, <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />D.B. <br />DRIVEWAY PERMIT <br />TOTAL <br />IGFSa <br />DC0UIT VAI meTInN <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />00 <br />CY'a <br />r- <br />0 <br />ADDRESS FIIF <br />