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�� <br /> � <br /> rhe Evc rr oF �7 NSTRUCTIO M <br /> everett PERMIT pERMIT NO. 11Z6O <br /> CITY HAIL 259�8745 <br /> EVERETf,WA 98201 ❑ COMBINATION ❑ BUILDINO Gt�cMECHANICAL ❑ PLUMBING <br /> OW��R MAIU�ORE55 GITY ZIP FMONE <br /> Harry' s Ei[KKI[YXSX Leather Shop Inc. 2712 xewitt 252_ <br /> ARGHIiECTOR0E51GNER MAILADDRE55 CIIY ZIP MONE <br /> GENEFR�fANTRACTON MAII RODRE55 CIIV ZIP VNONE LICENSE� <br /> Same <br /> MECNANICA�CANTFRCTOP MAILA�DRESS Cltt 21P WIONE UCENSEI <br /> PLUMBINGCONiRACTON MAILADORE55 GiY ZIP PMONE LIGENSE• 1 <br /> � <br /> CU55OF WORN <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VRLUI.TION OF WORK <br /> 5 <br /> DESCRIBE WORK <br /> Install wood atove <br /> PROPOSE�USE OF BUiIDING <br /> HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> �ecaioeseAiv.iorvoFvaovearvisMoweeiowoannncr�vouneoP�es PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORUINANCES GOVERNIN3 THIS <br /> ior eiocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMA E OF CONSTRUCTION. <br /> JOBADORE55 SiGNAiUACO�CANiRACiORORAII RIZEDAG f OAT[ <br /> 2712 Hewitt X '; 11/17/82 <br /> PLUMBIK 3 MECHAN ICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNITS—HP.EA. <br /> BATHTUB REFRIGERAiION UNITS—FI.P.EA <br /> LAVATORY p4ASH 6ASIN) BOILERS—HP.EA. <br /> SHOWER GASFlREDAC UNITS—TONNAGEEA. <br /> KITCMEN SINK 8 DISP. FORC[D AIFi SVSTEA75—�S.U. M EA. <br /> DISHWASHER 1YALL HEATERS—B.T.U. M <br /> IAUNDRV TRAV UNIT HENTERS—B.T.U. M <br /> CLOTHFS WASHER EVAPpRATIV[COQLEPS <br /> WATER HFATER CLOTHES DRVERS <br /> URINAI VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> F�ppq ORAIN AIR HANDLING UNIT— CF.M. <br /> VACUUM BRFAKERS ]. STOV[ hip <br /> ROOF ORAINS—RAINLEADERS METAL FlREPLACE 8 CHIMNEV <br /> SMK�SERP'CE—OAR,ETC.) <br /> SUB TOTAL SUB TO7AL f � 5 O <br /> PERMIT S PERMI7 � f <br /> TOTAL FEE f TO"AL FEE S <br /> SIDE YAPD SETBACH STPEET SET9ACK REAR VARD SETBACK PIAN CHECK NUM�ER PLAN CHECH FEE <br /> fEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANi SITE <br /> iiVES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING $ <br /> SIZE OF BLDG. NO.OF STOPIES MA%.OCQ LOAD <br /> PLUMBING <br /> FIRE ZONE �nSEMENT FlRE SPRINKLERS <br /> REOUIRED MECHANICAI 1� SO � <br /> C7YES I INO <br /> APPROVAlS BY DATE OTHEfl <br /> 1. ENVIRONMENiAL CHECK LIST <br /> PENALTV U.B.C. <br /> 2. BUILOIN�PU+NS SEC.303(a) <br /> 3. FIflF HVORA�JT TOTAL 1� S O <br /> a. FIPE PROTECTION SYSTEM PEHMIT VALIUATION <br /> WHEN PPOPERLV VAUDATED pN THIS SPACE)THIS IS VOUR PERMIT <br /> 5. GRADING O ' ` e • O I �..�0 _- � ' <br /> � 6. DRAINAGE ''° j <br /> 7. ENVIRONMEN7AL IMPACi STATEMENT N <br /> B. MEALTH 0151RIQ �YV�U;R (kEC�EIPT � <br /> APPUCAT;G�:ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BV <br /> � • 7t1ANK YOU <br /> • < . <br /> . ; � <br /> I7 � 81 <br /> l�DDRESS FILE <br />