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the Evergreert � �NST R U CTIO N <br /> GTY CF <br /> everett PERMIT PERMIT NO. OBCSO <br /> CITYHALL259�8745 � COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING <br /> EVERETT,VJA 98201 <br /> OWNEP MAILADDRESS QiY 21P PNONE <br /> Kenneth G. Cea 2828 Panaview Blvd. Everett 98203 353-5191 <br /> FRCNRECTOf10ESIGNER MAILADDRE55 GTV ZIP PMONE <br /> GENEFnLfAMRALTOR MAILAODRESS QTY ZIP PHONE UCENSEI <br /> Same <br /> MEGHFNICALCONiMCTOR MAILADDPESS GITY ZIP PlIONE LICENSE� <br /> PWMBINGGONTRAGiOR MAILA�ORE55 CITY ZIP PHONE UCENSEI <br /> C1A550F WOPK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WOFK <br /> f <br /> OESGRIBE WOPK <br /> install wood burning stove <br /> PROi'OSED USE OP�UILDING <br /> I HEREBY CERTIFY THAT I HAVE RE:.D AND EXP.MINED THIS AP- <br /> LEGAL'JESCRIPTIONOFPROPERTY(SMOWOELUWOFATTAGMFOURCOPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or e�oc�_nF TYPE OF WORK WILI 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 PERFORMANCE OF CONSTRUCTION. <br /> SIGNFI PE F CONiPACiOR 0 AU CRI.EO AG OATE <br /> JO�A���ESS <br /> 28e8 Panaview Blvd. X _ 12 11 SO <br /> PLUMBIN6 MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ROILET) AIR COND.UNITS—HP. EA. <br /> BATHTUD REFPIGERATION UNIiS—H.P.EA <br /> �,4VAiORY�lJASH BASIN) BOILERS—H.P.EA. <br /> SNOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK&DISP. FORCED AIR SYSTfMS—�.T.U. M EA. <br /> DISHWASHER WALL HEA7ER5—8 T.U. M <br /> LAUNDPY TRAY UNII HEATERS—�T.U. M1� <br /> CL01HE5 WASHER EVAFOiiATIVE COOLEFS <br /> \YATER HEATER CLOTHES DRYEPS <br /> URMAI VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRNN AIR HANDLING UNIT— C.F.M. <br /> VACUUM PREAKERS 1 STOVE WOOa <br /> ROOF DRAINS—FIAINLEAOERS METAL FIREPUICE&CHIMLEV <br /> SINK(SENVICE—BAR,ETC.) <br /> � <br /> 4 SUBTOTAL SUBTOTAI f <br /> PERMIT S PERMIT 5 3 00 <br /> TOTAL FEE S TOTAL FEE S 7 S O <br /> SIDE YARD SETBACK STflEET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PIAN CHECK FEE <br /> FEE PECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> lJYES f 1N0 FEES VALUA710N FEE <br /> TYPE OF CANST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> BUILDING 5 <br /> SIZE OF BLDG. N0.OF STOPIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENi REOUIRED KLERS MECHANICAL 7 50 <br /> ❑YES ❑NO <br /> APPflOVALS BY DATE OTHER <br /> 1. ENVIRONM�NTAL CHECK IIST PENAL7V U.BC. <br /> SEC.303�a) <br /> Y. BUILDING PLANS <br /> 3. FIRE HYDRANT <br /> TOTAL 7 50 <br /> o FIFE PROTECTION SYSTEM PEHMIT VALIOATION <br /> __ 1YHEN PROPERLY VALIDATED(IN THIS SPACE)THI$IS YOUR PERMIT <br /> 5. uhADING I 5 5 5 � 0 01. 5 0 -� <br /> 6. OPAINAGE . <br /> 7. ENVIRON'AENTAL IMPACT STATEMENT � <br /> 8. HEALTH DISTFICT � ' f? n ,^(_'f��O <br /> f <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY <br /> , � . ,.� �.,�, � <br /> :i� 1 l <br /> V. C. <br /> I 4 �-�C u 0 <br /> ADDRESS FILE <br />