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the E1'CgV OF <br />"O N ST R U CTI O`+I <br />everett <br />PERMIT <br />PERMIT NO.10232 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />❑ COMBINATION ❑ BUILDING ZMECHANICAL <br />❑ PLUMBING <br />C OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Scott Silverwood <br />1827 Rainier Avenue Everett <br />98201 <br />259-3633 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />PHONE LICENSE If <br />MAIL ADDRESS CITY <br />ZIP <br />MECHANICAL CONTRACTOR <br />PHONE LICENSE 1 <br />MAIL ADDRESS CITY <br />ZIP <br />Same <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE IF <br />CLASS OF WORK <br />❑NEW []ADDITION ❑ALTERATION ❑REPAIR El DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />S <br />SCRIBE WORK <br />install wood stove <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />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 PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF WNTRACTO OR 4UTHORIZED AGENT DATE <br />X 2/17/82 <br />--_ <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT -BLOCK -OF <br />JOB ADDRESS <br />1827 Rainier Avenue <br />PLUMBING <br />M HANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE _ <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — N.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />_ <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS — B T.U. At EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />— <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANG[ HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />1 <br />STOVE Wood <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUBTOTAL <br />SUBTOTAL S7 <br />50 <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL <br />FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$ <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />DYES ONO <br />MECHANICAL <br />17 <br />50 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />17 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />8 8 5 7 $ 0 17. 5 0 --�1 <br />co <br />f� N <br />�I , , I R R tC E IPh <br />i_ I A N K YOU <br />S. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8, HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />AFPR. FOR ISSUANCE BY <br />J <br />1 7 FIG u 2 <br />ADDRESS FILE <br />