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nc�Ercrgrcc+i <br /> everett r v4NSTRUCTlO� � <br /> PERMIT PeRnnir No. 15624 <br /> CITY HALL 259�87d5 <br /> EVERETT,WA98207 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> i <br /> OWNER MAIL AD�RESS CITY <'IP PNONE <br /> Ken Smith 1617 Oakes Everett WA 252-8831 <br /> ARCNREGi OR DESIGNER MAIL AO�RE55 CITY 21P PMONE <br /> GENEPAL CONTRAGTOR MAIL AODFSSS CIiY ZIP PNONE LICENSE� <br /> MECHANIC�LCONTRAGTOR MAILAODRESS dTY ZIP PNONE LIGENSEI <br /> Puget Heating PO Box 336 Lake Stevens 98256 334-4111 223-02-PUGETH2648A <br /> PIUMBING CONTRACTOR MFIL PDDFE55 CITY Zlp PNONE 4CENSE M <br /> C1A55 OF K'ORK <br /> ❑NEW ❑AD�ITION C� ALTERATION ❑REPAIR ❑ DEMOLITION O FENGE ❑ SIGN ❑ 1YOOD STOVFJFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S <br /> �ESCRIBE WORK <br /> Convert electric furnace to gas <br /> PROPOSED USE OF BUILDING H <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND •• <br /> �EGALDESCRIPTIONOFPROPERiY�SMOWBELOWORATTACMFOURGOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_B�OCN_OF 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 VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR � � <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE � <br /> PERFORMANCE OF CONSTRUCTION. �'' <br /> � <br /> JOB ADDRESS EI RE OF CONTRACTOR OR RUTH EO AGENT DFTE <br /> 1617 Oakes 10/25/85 � <br /> PLUMBINO M HANICAL y <br /> O <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> WATERCIOSET�TOILEn AIR COND.UNI7S-H.P. EA. <br /> BATHTUB REFRIGERATION UNITS- H.P.EA. z <br /> LAVATORV(WASH BASIN) BOILERS- H.P. EA. � � <br /> SHOWER GAS FIRED A.C. UNITS-TONNAGE EA. �„� <br /> KITCHEN SINK 8 DISP. 1 FORCED AIR SYSTEMS- B.T.U. M EA. 4 SO � <br /> DISHWASHER WALL HEATERS- B.T.tI. M � � <br /> LAUNDRYTRAY UNIT MEATERS- B.T.U. M � <br /> CLOTHES WASHER EVAPORATIVE COOLERS � <br /> WATER HEA7ER CLOTHES DHVERS ~ <br /> N <br /> URINAL VENTII.ATION FAN _ � <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- C.F.M. �] <br /> VACUUM BREAKERS STOVE-WOOD • � <br /> ROOF DRAINS- RAINLEADERS METAL FIREPLACE d CHIMNEY <br /> SINK(SERVICE- BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP yy <br /> 1 Z <br /> � <br /> H <br /> SUB TOTAL S SUB TOTIIL f 6 50 Ny <br /> PERMIT f PERMIT f 1 00 O <br /> TO7AL FEE f TOTAL FEE S H <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN GHECK PEE � <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> �iYES ;;NO FEES VALUATION FEE <br /> TYPE OF CONSI�. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOAD <br /> PLUMBING <br /> FIRE ZONE BASEME!VT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED 16 SO <br /> "YES I .NO <br /> APPROVALS BY DATE OTMER <br /> L ENVIRONM1'.cNTAL CHECK LIST PENALTY U B.C. <br /> 2.BUILDING PLANS SEC.�03(a) <br /> 3.FIREHVDRANT TOTAL 16 SO <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> S.GRADING WMEN PROPERLY VALIDA7ED pN TM14 GP,a 1 THIS 1S�YQUR PER�MIT ;:� <br /> 6.DRAINAGE o I G 5 <br /> c, � <br /> 7.ENVIRONMENTALIMPACTS7ATEMEhT �.- <br /> 8,HEALTH DISTRIC7 � <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR.FOR ISSUANCE BY �i �, �� i. r��c r-i�r � <br /> ,;" �•cau � <br /> �� : � „ ,. <br /> ADDRESS FlLE ) 5 �rT b 5 <br />