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owawvom <br />CITY OF 40 INSTRUCTION <br />everett PERMIT PERMIT NO. 17180 <br />259-8745 <br />Cl DEMOLITION ❑ COMBINATION ❑ BUILDING ® MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Gail Thompson 2102 Rainier Everett 98201 259-1450 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE IF <br />N= <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE <br />Natural Gas Eaviffient CO--inc,1625 <br />PLUMBING CONTRACTOR <br />E. <br />MAIL ADDRESS <br />Marine View Dr Everett 98201 <br />CITY ZIP <br />258 2441 <br />PHONE LICENSEE <br />CLASS OF WORK <br />NATDRGE320N6 <br />❑ NEW ❑ ADDITION <br />IR ALTERATION <br />❑ REPAIR ❑ DEMOLITION <br />❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />I <br />Install, gas pipe boiler <br />HEAT SOURCE <br />Cl ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Residential <br />I HEREBY CERTIFY THAT I 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 />SIG T PE OF CONTRACTOR. AUTHORIZED AGENT, OR OWNER DA E <br />X <br />MEC NICA <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />2102 Rainier <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />I TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC — A/HNDLG UNITS — H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA. <br />LAVATORY (WASH BASIN) <br />I <br />BOILERS — R T.U./H P. <br />16 <br />S <br />SHOWER <br />GAS FIRED AC UNITS—B.T.U. <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS — B T.U. M EA <br />DISHWASHER <br />WALL HEATERS —BT.U. M <br />LAUNDRY TRAY <br />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 />RANGEHOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />6 <br />So <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK(SERVICE — BAR. ETC.) <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />S <br />SUBTOTAL <br />PERMIT <br />$ <br />PERMIT S <br />1S <br />OU <br />TOTAL FEE <br />$ <br />TOTALFEE 5 <br />IA <br />00 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />V ION <br />F <br />BUILDING <br />/ <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />W=17180 <br />SIZE. OF BLDG <br />NO OF STORIES <br />FAX OCC LOAD <br />MECHANICAL <br />CHECK -111.00 <br />3 <br />00 <br />FIRE SPRINKLERS REOUIRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />Sec 304)e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />M. M. <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE <br />BY <br />DRIVEWAY PERMIT <br />TOTAL <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />00 <br />r <br />L` <br />r!..:I .c F1, , <br />