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�'� � �NSTRUCTION � � : ^ <br /> �_�� PERMIT PERMITNQ,:17689 <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDINO �1 MECHANICAL ❑ PLUM91N0 ❑ SION <br /> � Lorraine F. Smith 2401 P�ne�� WA 98201`�TM Z�P 259-54� <br /> �verett, <br /> ,wp�ihcronoes�ar�n MAILAUORESS cm nv aHa� <br /> 6ENEMLCONiR�CTOR MAIL ODF=SS CITY 21P PMONE UCENSE� <br /> J1m's Stoves Lynnwooa <br /> MECHNIICAL CONTR�CTOR MAIL F�DNE55 CITY ZIP PHONE LICENSE� <br /> PLUMBINGCONTRACTOii M�IL�ODRE55 CITV ZIP PHONE LICENSE• <br /> CL�SS OF WDlik <br /> � NEW ❑ ADDITION O ALTERATION ❑ REPAIR C DEMOLITION ❑ BUILDINQ RELOCATION <br /> V�LU�TION OF WORI( <br /> S <br /> pESCRIBE WORK <br /> Install Woodstove <br /> HEATSOUHCE <br /> ❑ EIECTRICIri ❑ f3A8 ❑ WOODSTOVE ❑ OTHEH <br /> PROPOSED USE OF BUILDING <br /> Single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND 'r(NOW THE SAME TO BE TRUE AND <br /> LEG�LDESCRIPTIONOFPROPERTY�SMO\YBELOWORATfACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �oT 15&�aK 54�oF Mil e Land Co. $. 31'd Add. 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 PERF RMANCE OF CONSTRUCTION. <br /> JOB AUDRE55 S� ,UR F CONTRACTOR.RUTI� R12 AGE .OF OWNER QATE /� <br /> 2401 Rdf Pine $� , �?a� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FII(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/MND�G UNITS—HP. <br /> BATHTUB FEFRIGERATION UNITS—H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS—B.T.U1H P. <br /> SMOWER GAS FIFED A.C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNDiiV TRAY UNIT HEATEFS—B.T.U. M <br /> CLOTHES WASHER EVAFORATIVE COOLERS <br /> URINAL CLOTHESORVERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BACKFLOW PREVENTERS WATER HEATER • <br /> ROOF DRAINS—RAINLEADERS 1 WOOD STOVE <br /> SINK(SFRVICE—BAR.ETC.) METAL FIPEPLACE 8 CHIMNEY <br /> FIREPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUBTOTAL S SUBTOTAL <br /> VERMIT f PENMIT <br /> TOTAL FEE S TOTAL FEE <br /> FRONT SETB�CK aFAR SETBnCN SiOE SETBnCK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> USEZONE LOTRREA ypLANT5ITE <br /> ❑res ❑No FEES VALUATION FEE <br /> TYPEOFCONST OCCUPANGYGROUP NOOFDWEIUNGUNITS BUILDING L� �� ��Z'�,.^_Q ����K�C <br /> PLUMBING � <br /> SIZE OF BLDG. NO OF STORIES MA% OCC LOpD <br /> MECHANICAL �H $, O,�Q 3 O OO <br /> INVESTIGATION FEE ���11e) %' �' <br /> FIRE SPRINKLERS REOUIRED �ES NO <br /> STATE BUILDING SURCHARGE <br /> STATEENERGVSURCHARGE <br /> qPPLICATION ACC.BY PlANS CHECKED 13Y APPR fOR ISSUANLE DY <br /> ❑RIVEWAV PERMIT <br /> S•H• TOTAL 3O O <br /> PERMIT l'ALIOATION <br /> WHEN PflOPERLY VALIDATED�1N THIS SPACE)THIS IS VOUR PERMIT <br /> Q1 <br /> � <br /> �� <br /> �� <br /> r� <br /> r.00r,Ess ri�E <br />