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`,'�E,���Y��n ; ^ONSTRUCTIOP' <br /> everett PERMIT PERMIT NO. �Z6O4 <br /> CITY HALL 259�07d5 <br /> EVERE7T,WA98207 � COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> OWNER MAII ApORE55 CITY ZIP PHONE <br /> PAUL FORSTER 1125 DWPLE �erett WA 9820_L 252-6167 <br /> FHGMITECT Ofl DESIGNER MAII ADDRESS CIiY ZIP PHONE <br /> GENEFRL CONTPAGTOR NAIL AD�PE55 CITY 21P PMONE UCENSE I <br /> MECHANIGAL CONTRAGTOR iARIL RODR[SS CITY 21P PNONE LICENSE 1 <br /> Same <br /> PLUMBING GONTRAGTOR MAIL ADDRE55 CITY ZIP PHONE LICENSE I <br /> GWSS OF WORN <br /> XXNEW ❑ pODITION ❑ ALiERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VALUFTION OF WORK <br /> S <br /> DESCHIBE 1VJRK . <br /> Install wood stove <br /> PROPOSED USE OF BUIL�ING <br /> Residence I H.:REBY CERTIFY THAT I HAVE READ AND EXAh11NED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND � <br /> LEGAL�ESGRIPTION OF PROPERTY(SHOW BCLOW OR ATfRCN FOUR GOPIES� CORRECT. ALl PROVISIONS OF LAWS AND ORDINANCES �� <br /> �oT13$1��ocKZZ�oF EVerett "T" 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 STATE OR N M <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE .; �+y <br /> PERFO, E F CO STRUCTION. H �] <br /> JOB ADORE55 SIGNAT OR HORIZED AGENT O�TE U1 .T. <br /> 1125 Ma le X _ 10 24 83 � �T� <br /> PLUMBIN6 MECNANICAL y <br /> N0. TYPE OF FUCTURE OR ITEM FEE NO. riPE OF EOUIPMENT FEE 6 <br /> WATER CLOSET�TOILE� AIR GOND.UNITS—H.P. EA. � <br /> BATHTUB REFRIGEFiATION UNITS— H.P. EA. �„� <br /> IAVATORV(WASH BASIN) BOILERS— H.P. EA. � Z <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. � <br /> KiTGHEN SINK 8 DISP. FORCED AIR SVSLEMS— B.7.U. M EA. y ~ <br /> DISHWASHER WALL HEATERS— B.T.U. M �i N <br /> LAUNORY TRAV UNIT HEATERS— e.T.U. M r0i� � <br /> CLOTHF.S WASHER EVAPORATIVE COOLERS _ � <br /> WATER HEATER CLOTHES DRVEAS N <br /> URINAL VENTILATION FAN <br /> DRIM1KITlG FOt1NTAIN _ RANGE HO00 � <br /> FLOOR ORAIN AIR HANOLING UNIT— C.F.M. <br /> VACUUM BHEAKERS ], STOVE—WOOD � S . � <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIfANEY <br /> SINK(SERVICE— BAR,ETC.) FIREPLACE INSERT <br /> _ HEAT PUMP _ � <br /> � <br /> � <br /> SUB TOTAL 5 SUB TOTAL = � SO y <br /> PEHMIT S PEHMI7 S 1Q QD y <br /> TOTAL FEE f TOTAL FEE S 1� SO � <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SEIBACN PLAN CHECK Nl1MBER PLAN CHECK FEE n <br /> FEE RECEIPT NO. M <br /> USE ZONE LOT AREA VACANT SITE <br /> f-:YES �.�,NO FEES VALUATION FEE <br /> NPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> uIZE Of BLDG. NO.OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEAIENT FIflE SPRINKLERS MECHANICAL LT iSO <br /> REOUIRED <br /> �. -.YES �-NO --- <br /> APPROVALS 9Y DATE OTHER <br /> 1.ENVIRONMENTAL CHECK L15T pENA�T� U B.C. <br /> SEC.30J�a) <br /> 2.BUILDINGPLANS 1� SD <br /> TO7AL <br /> 3.FIRE HYDRANT <br /> 4.FIRE PRO7ECTION SYS7EM PERMIT VALIDATION <br /> S.GFADING WHEN PROPERLV VALIDATED(IN THI j!i jC5 THIS�S�O�JR�P�1�1T_� <br /> � � � �N <br /> 6.DRAINAGE <br /> � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT N <br /> B.HEAITH OISTRICT <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY `��;? � � ���=��P7`� <br /> ". I i ,'��I t: Y O U <br /> 2 � <br /> I; UCT u S <br /> ADD"PSS FILE <br />