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lhi� Ll�erereert <br /> everett f �ONSTRUC,TIC` V 1 <br /> PERMl� PERMIT NO. - 2� � 5 <br /> CITV HALL 259�8745 <br /> EVERETT.WA90201 [j COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> OWNER IdAIIAD�RE55 QTY :IP PMONE � <br /> Richard Deibler 2216 Jade Everett <br /> ARGMIiECi OR OESiGNER MAIL ApORE55 CItY ZiP PMONE <br /> GENEHFL CONiRAGTOfl ldAIL p��9E$5 CITT $IP PMONE LICENSE• <br /> MEGMANICAL CONTRACTOR MAIL ADORE55 CrtY ZIP PNONE L'CENSE� <br /> Natural Gas Equipment 1611 E. Grand Everett WA 258-2441 ' <br /> PWMBVIG CONTRNCiON MAIL ApDPE55 CITV ZIP PMONE LICENSE r <br /> CLF55 OF\YORH <br /> MY NEW ❑ ADDITION ❑ ALTERATION �REPAIR ❑ DEMOUTION ❑ FENCE ❑ SIGN ❑ WO00 STOVEIFIREPLACE INSERT <br /> VALUFTION OF WORK <br /> Y <br /> OESCRIBE\40RK <br /> Install hot water heater <br /> PFOPOSED USE OF BUIL�ING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPt10N OF PROPERTV�SMpW dELOW OR ATTACM FOUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOt_BLOCN__OF 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 VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> J00 ADDRE55 SiGNATUflE OF C�O ITRAC70 ON At1iH0 ED AGEN� OAfE <br /> 2216 Jade X � , � �� � 7/13/83 <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE Nil. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET� AIR COND. UNITS— H.P. EA. <br /> BATHTUB RFFRIGERATION UNITS — H.P. EA. <br /> LAVATORY�WASH BASIN) 601LER5— H.P. EA. <br /> SHOWER GAS FIRED A.C. UNITS — TONNAGE EA. <br /> KITCHEN SINK 8 DISP. F-ORCED AIR SVSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL MEATERS— B.T.U. M <br /> � LFUNDRYTRAV UIJIT HEATERS— B.T.0 M <br /> CLO7HES WASHER EVAPORATNE COOLEPS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOH ORF!tJ Alfl HANOLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE — VJOOD <br /> ROOF DRAINS— RAMLEADERS METAL FIPEPLACE 8 CHIMNEV <br /> SINK�SERVICE — OAR, ETC.) FIREPLACEINSERT <br /> HEAT PUMP <br /> 1 hot water heater 4 50 <br /> SUB TOTAL S SUB TOTAL S Q 5O <br /> PEiiMIT 5 PERMIT S �O OO <br /> TOTAL FEE 5 TOTALFEE S �Q 5O <br /> SIDE YARD$ETBACK STflEEi5ET8ACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CH[CK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE - — <br /> VES NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO, OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MA%, OCG LOAD - <br /> PLUMBING <br /> � <br /> FIRE ZONE BASEMENT qEOUSRED KLERS MECHANICAL 14 5O � <br /> YES NO <br /> APPROVALS BY OATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST pENA�T� U B C. <br /> 2.BUILDING PLANS SEC.309(a) <br /> 3.FIRE HYDRANT TOTAL �4 5O <br /> d.FIRE PROTECiION SYSTEM PERMIT VALIDATION <br /> 5.GRADING VlHEM1 PROPERLY VALIDATED pN 7HI5 S�P'C�E��THIS I$�,YAUQ q,ER�AI�j �}') A <br /> 6.ORAINAGE i i � a U I 4 7 U pa4 <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � <br /> B.HEALTH DISTRICT � �{ � <br /> APPLICATION ACC. BY PLANS CHECKED BV APPR.FOfl ISSUANCE BV Y'-� U n t\E C E I Pl� <br /> � �,-�r'.�,1!, ���� U <br /> I ti �"��� U.� <br />