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`,'c`°�TreoF ('�NSTRUCTION <br />everett PERNlIT pFRMIT N0. 10495 <br />CITY NALI 259�0745 <br />EVERETL WA 9�207 ❑ COMBINATION �I BUILDING Q MECHANICAL ❑ PLUMBING <br />OWNEF MAILAUf1HE55 CIIY ZiP PHONE <br />Larzy J. Holzerland 1332 Mukilteo Blvd. Everett 98203 259-6494 <br />ARCMITECi OR pESIGNER 1,IqIL AD�PBSS CITY ZIP PIIONE <br />GENERAI CU4iRFCiOR MAIL ADDRESS CIiV ZIP PIIUNE ULENSE / <br />Same <br />MECMANICALCONiqACiOR MAILAO�RESS CITY 21P PIIONE LICENSF.� <br />PlUM81NGCONiRACTOR MAILAppRESS � CITY 21P PMONE UCENSE� <br />CLASS OF WORN <br />❑NEW ❑ADDITION ❑AL7ERATION IiAYEPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VPWAtION Of 1VORK <br />f zOli. �0 <br />0[$CRIBE WOFK <br />construct Ma <br />PROVOSED USE OF pUILDING <br />ior e�aK_oF <br />iry chimney and install wood stove <br />I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS AP� <br />BELOWORATTACNFOUIILOPIES) PLICATIOP� AND I:NOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES C.DVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HLREIN 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 TATE OR LOCAL L4W REGULATING <br />CONST CTION(((JJJ'''���)))��� T E RFORMAN(J�y—�_��` ONSTRUCTION. <br />9C�FCONiRA�Ji�pRO AU RIZSO/(�Ni � pATE <br />1332 Mukilteo Blvd. X niA./ �� /iL� .w. 4/26/82 <br />PLUMBING <br />NC. TYPE OF ��I%TURE OF <br />EN SINK 8 DISP. <br />DRMKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKEflS <br />ROOF �RAINS — RAI <br />SINK ISERVICE — BAI <br />SIDE VARD SETB�CK <br />USE 7.ONE <br />FIRE ZONE <br />STPEEI SETBACK <br />LOT AREA <br />t. EM9RONMcNTAL CHECK UST <br />2. BUILDING PIANS <br />3. FIRF. HYDRANT � <br />.;. FlRL PROTECTION SYSTEU <br />5. GRADING �G <br />Q�7. ENVII <br />�. HEAL <br />APPLICATION ACQ OV <br />c° -C C) <br />�' Q m <br />— r" �– <br />—I <br />n <br />MECHANI�L v � <br />FEE NO. TY?E OF EOUIPMENT <br />41R COND. UNITS — H.P. EA <br />REFRIGGRATIONUNITS—HP EA <br />�OILEFS — FIP. EA. <br />GAS FIflED AQ UNITS — TONNAGE EA. <br />FORCEDAIRSY;TEMS—BT.U. M <br />WALL HEATERS — BS.U. M <br />UNIi HFATEHS — d i.U. A1 <br />E1'AFti1RATIVE COOLERS <br />CLOiHES DRYERS <br />VENTILATION FAN <br />flANGEHOOD <br />AIR HANDLI4G UNIT — C <br />1 STOVE , O �j <br />METAL FIRLPLACE & CHIAINE7 <br />REAR YARD $ET�ACK �PLAtJ CNECK NUM�ER <br />[]YES ❑NO <br />NO. OF DWELLING UNITS <br />BUILDING <br />MA%.00C LOAO <br />PLUMPING <br />FIRE SPRINRLERS <br />REOUIRE� MECHANICA� <br />I'YES CNO <br />BY DATE OTHER <br />PENALTY <br />TOTAL <br />CHECKED BY � APPP. FOR ISSUANCE �'� <br />PERMIT <br />FEE <br />5200. <br />U.P C. <br />SEC.303(a) <br />'-E <br />RECEIPT NO. <br />FEE <br />10 00 <br />1% 5� <br />WHEN PiiOPEfiLY 7ALIDATED (IN THIS SPACEI THIS IS YOUR PER611T <br />1724 SOIU.UU- '�; <br />� <br />0 <br />Y�U:P, RECCIPT � <br />71i�NK YOU <br />ADDRESS FILE <br />���.PRg? <br />� <br />..J <br />