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the Evergyrm <br />OTY OF <br />CnNSTRUCTION <br />everett PERMIT <br />259-8745 <br />PERMIT NQ: - f U <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ® MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Ed Coon 2621 Hillside Lane Everett 355-6326 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />G&S Heating 500 E. Main Monroe 98272 794-7306 &9=E dt88$R GSHEACT147JD <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSED <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ER ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />electirc furnace to gas and hot water tank. <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Residence <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGAA UTHOFd EO ENT. OR OWNER DATE <br />�g <br />LEGAL DESCRIPTION OF PROPERTY ISIIOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />2621 Hillside Y Lane <br />PLUMBING <br />MEd NICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />tYPt OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-AMNDLG UNITS — H P <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY ( WASH BASIN) <br />BOILERS— BTU HP <br />SHOWER <br />GAS FIRED A C. UNITS — B.T.U. <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS — R T.0 M EA. <br />DISHWASHER <br />WALL HEATERS — BTU M <br />LAUNDRY TRAY <br />I UNIT HEATERS — B T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />1 <br />WATER HEATER <br />6 <br />50 <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.) <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />2 <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />$ <br />SUB TOTAL <br />15 <br />50 <br />PERMIT <br />S <br />PERMIT <br />15 <br />00 <br />TOTAL FEE <br />$ <br />TOTAL FEE <br />30 <br />50 <br />FRONT SETBACK <br />REAR SETBACK SIDE <br />SETFACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA VACANT <br />SITE <br />DYES ONO <br />FEES <br />BUILDING <br />S <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 />MEW <br />CHECK $ <br />59 <br />.50 30 <br />50 <br />FIRE SPRINKLERS RECURRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />Sec. 304(c) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />S.H. <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />30 <br />50 <br />PFRMIT WAUDATION <br />WHEN PROPERLY VALIDATED IN THIS SPACE) THIS 15 YOUR PERMIT <br />RO5(1["S FI'I_E <br />