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theEvffwvm <br />CITY OF <br />everett <br />259-8745 <br />CnNSTRUCTION <br />PERMIT <br />PERMIT Ill 19413 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ja MECHANICAL '❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS <br />CITY 21P PHONE <br />George Garul 2518 Monroe Ave. Everett, WA 98201 353-0078 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSED <br />M.CHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE• <br />Valley Natural Gas <br />11303 Hwy 99 Everett, WA <br />96204 <br />355-7730 VALLENG153LI <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE• <br />❑ NEW ❑ ADDITION aALTERATION ❑ REPAIR O DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />DESCRIBE WORK <br />Install furnace/Waterheater. <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Single family residence <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 />SIGNATURE CF CONT TOR. THORIZED AGENT. OR OWNER DATE <br />OL <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />JOU ADDRESS L' b <br />-25i4'Monroe Ave. <br />PLUMBING <br />ME ANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />-N-OF <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />XC — A/HNDLG UNITS— H P. <br />BATHTUB <br />REFRIGERATION UNITS — H P EA. <br />LAVATORY ('WASH BASIN) <br />BOILERS — B.T.U./H.P. <br />SHOWER <br />GAS FIRED A.C. UNITS — D T.U. <br />KITCHEN SINK It DISP. <br />1 <br />FORCED AIR SYSTEMS — B.T.U. M EA <br />9 <br />00 <br />DISHWASHER <br />WALL HEATERS — BT.0 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 />RANGE HOOD <br />BACKFLOW PREVENTERS <br />L <br />WATER HEATER <br />6 <br />SO <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC) <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACE INSERT <br />HEATPUMP <br />2 <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />f <br />SUBTOTAL <br />15 <br />0 <br />PERMIT <br />f <br />M-RMITS <br />15100 <br />TOTAL FEE <br />S. <br />TOTAL FEE S <br />30150 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCU?ANCVGROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />PLUMBING <br />SIZE Of OIDG <br />NO Of STORIES <br />MAX OCC LC AD <br />MECHANICAL <br />30 <br />50 <br />FIRE SPRINKLERS REOUIRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />_ <br />SEC. 3041e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />.SH. <br />PLANS Cl IECKED BY <br />APPR FOR ISSUANCE <br />BY <br />DRIVEWAY PERIdfE <br />TOTAL <br />30 <br />SO <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />ADDRESS FILE <br />