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- ,,,`,-,`,,`."° rONSTRI� CTION <br /> everett p�R�11T PERMIT N0. 1��� � <br /> ciTY r:.��zsea�ns � '—' MECHANICAL ❑ PLUMBING <br /> EVERETT.�7n 86201 ❑ COMBINATiON BUILQING �1�X <br /> Z�p oMONE <br /> I.IPiL ADDRE55 ���Y � <br /> ovn+eF }werett 98201 259-3886 <br /> Gordon Bustad 3221 Kromer GITY z�v aror+e <br /> rena nvoaess <br /> qpGMIiECT OR OE9GNEF <br /> MAIL ADDAE55 GITY <br /> 21P PNONE LICENSE+ <br /> GENERA��O4iRACTOR <br /> Z�P pqp��E LiGENSE+ <br /> MAIL RDDRESS CITV <br /> MEGHANICALGOAiRAGTOP <br /> SA1�e CITv ZIP PHONE LILE��SE• <br /> MAi.ADDREcS <br /> PLUMBING CONTRAGTOR <br /> GLA55 OF WORN <br /> �ryEyr ❑ AODITION ❑ A�TERFTION O REPAIR ❑ DEMOLITION O FENCE ❑ SIGN �I N100D STOVFIFIREPLACE INSER <br /> VAIUATiON OF WORK <br /> S <br /> OESCRiBE WORN � <br /> Install wood burning stove .__— <br /> vaoPoseo use oF euaoiN'. I HtREBY CERTIFY THAT I HAVE READ AND EiCAMINED THIS H <br /> h <br /> single family residence _ APPLICATION AND KNOW THE SAME TO BE TRUE AN <br /> LEGPLDSG��PTtONOFPPOPEFTY�SHOWBELOWORATTACNFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING ThIS TYPE OF WORK WILL 9E COMPLIED WITH <br /> �p.__g�p�g_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEI THE PROVISIONS OF AN���CTION SOR T�E y � <br /> p�RFORMAN OFCONS RUCCO <br /> onre �' t�f <br /> SIGNATUREOF IHAGiOROHFUilIOP' � PGE1(S 1z�Z��Ba nn�J <br /> ��J�AO�AE55 X �N C*1 44 <br /> 3218 Kromer � <br /> MECH NICAL FEE '� <br /> pLUMBING TYPE OF EOUIPh/ENT _ <br /> FEE N0. <br /> NO. TYPE OF FIXTURE OR ITEM q�q CON�.UNITS— H.P. EA. _ � <br /> WATERCLOSET�TOIIET) REFPIGERATION UNITS — M.P. EA. _,,, <br /> BATHTUB BOILEFS— M.P.EA. — z <br /> LAVATORV(WASH BASIN� GAS FIRED A.C.UNITS—TONNAGE EA. � � <br /> SHOWEH FORCED AIH SYSTEMS— B.T.U. M EA. � � <br /> M N <br /> KITCHEN SINK 8 DISP. y./p�L MEATERS— g�T��� — � <br /> DISMWASHER UNIT HEATERS— BT.U. M � <br /> LAUNDRYTRAY EypppRATIVEGOOLERS .�. <br /> _ CLUTHES WASMER CLOTHES ORYERS [x� N <br /> WATEF HEATER yENTILATION FAN L <br /> URINAL ppNGE MOO� M <br /> DRINKING FOUNTAIN q�p HqNDLING UNIT— C.F.M. V� <br /> FLOOR DRAIN 1 � SO <br /> STOVE—�'�'OOD , � <br /> VACUUM BREAHERS METAL FIREPLACE 8 CHIIdNEV _ <br /> ROOF DRAINS— RNINLFi.DERS FIREPLACE WSERT -- <br /> _ SINK�SERVICf — B4R.ETC) HEq7 pUMP � <br /> SUB TOTAL S � Sd � <br /> SUB TOTAL ' pERNIT = I.O OO 'y <br /> PERMIT S 70TAL FEE S ].� SO O <br /> TOTAL FEE S p�AN CHECK FEE y <br /> RECEIPT NO. M <br /> SIDF�AAD SETBACN STREET SETBACK flEAR YARO SETBACK PLAN CHECK NUMBE FEE _ <br /> yACANT S�TE yALUATION FEE <br /> USEZONE LOT AREA FEES <br /> y�g NO <br /> TYPE OF CONST. OCCUPANCY G70UP NO.OF DWELUNG UNITS S <br /> BUILDING — <br /> SIZE OF BLDG. NO.OF STORIES M�x.OCC.LOAD pLUMBING -- <br /> 17 50 <br /> BASEMENT FIRESPRINKLEPS MECHANICAL - <br /> FIRE ZONE q�OUIPED <br /> VES NO OTMER <br /> APPROVALS BY DATE U B.C. <br /> 1.ENVIflONMENTAL CHECK L15T PENAL?Y SEC.903(a� 1� SO <br /> 2.BUILDING PLANS T�TA� <br /> 3.FIRE HYORANT pERM1T VALIDATION � � <br /> 4.FIRE PFOTECTION SYSTEM VlHEN PROVERLY VALIDATED I�N THIS�SPAC(�TNIS IS VOVRBEPMiT � <br /> 5.GRADING N <br /> fi.DRPINAGE . . LF <br /> 7.ENVIRUNMENTALIMPACTSTFTEMENT � � <br /> 8.HEAITH DISTRICT <br /> ppPLICATION ACC. 9Y PLANS CHECKE�BY APPR.FOHISSUANCEBY <br /> :�,Df712CSS I I�'�� <br />