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rem <br />[he EU C everet'"ONSTRIUCTI�DN q <br />ev PERMIT PERMITNQ:;- i �587. <br />259-8745 8745 - <br />® DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Wm. P. Brust <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />Fuller & Son P.O. Box 1134 Everett,WA 98206 424-5640 FULLES15OL4 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />Cl NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR $] DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />DESCRIBE WORK <br />Demolition <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE <br />❑ 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 PERFORMANC: OF CONSTRUCTION. <br />SIGNATUR FCONTRA O AU HORIZEO AGENT. OR OWNER DATE <br />X r 12/22/8 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />9 & 10 16 Plat of South Park Addition <br />LOT _ BLOCK _ of <br />to Everett <br />JOB ADDRESS <br />4117 Hoyt Ave <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 />AIC — A/HNDLG UNITS — H P. <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA. <br />LAVATORY ( WASH BASIN) <br />BOILERS — 8 T.U./H. P. <br />SHOWER <br />GAS FIRED A.C. UNITS — B.T.U. <br />KITCHEN SINK 8 DISR <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <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 />FLOUR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.) <br />METAL FIREPLACE & CHIMNEY <br />_ <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />f <br />SUBTOTAL <br />PERMIT <br />f <br />PERMIT <br />TOTALFEE <br />$1 <br />TOTALFEE <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />—0— <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO OF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REQUIRED ❑ YES NO <br />INVESTIGATION FEE <br />SeC. 304(e) <br />STATE BUILDING SURCHARGE <br />1 <br />50 <br />STATE ENERGY SURCHARGE <br />12/22/81) O <br />PM 000A03409 <br />1*' <br />APPLICATION ACC. BY <br />M.M. <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />E SRCH $t.50 <br />1150 <br />ocouITUAIInATIAU <br />•� <br />WHEN PROPERLY VALIDATED (IN T •)(ACE) THISjgy0AR PERMIT <br />CHECK $4.00 N <br />Cb <br />L0 <br />T- <br />AC'DIIESS I It E <br />