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'," '�`�T���' � ^ON�TRUCTION <br /> everett PERMIT PERMIT N0. �4O7H <br /> CITY MALL 259�B7d5 <br /> EVEr7ETT.WA98201 ❑ COMBINATION ❑ BUILDING ((�'j4 MECHANICAL ❑ PLUMBING <br /> OWNER MARR�DRE55 GTv ZIP PMONE <br /> VERLAND NOLTA 2?13 Maple Street Everett WA 96201 258-1927 <br /> ARCN�TECT OH DESIGNER MAR ALORE55 GITY Zio PHONE <br /> GENERALGONTPAGTON MAIL4pCRE5S CITY ZIP PMONE IIGENSE• <br /> MECNANICAL CONTPAGTOR MAIL AD�RE55 CITV ZIP PMONE LICENSE♦ <br /> PLUMBING CON7�iAGiOR MAIL hDDRE55 CITY 21P PMONE LIGENSE� <br /> C1A55 OF V�ORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ,[X WOOD STOVEIFIREPLACE INSERT <br /> VALl1ATI0Y OF WORK <br /> S <br /> DESCRIBE WORN <br /> Install wood heater <br /> JROPOSED USE OF BUILDING <br /> Resi dence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGRL DESCNIPTION OF PPOPERTY(SHOW DELOW OH ATTACH FOUR GOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED Wi;H <br /> LOT,BLOCK_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRAhTIN(? JF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOC.4L LAW REGULATING CONSTRUCTION OR THE <br /> PERFOHMANCE OF CONSTRUCTION. <br /> J�0 AD�RESS SiG ATURE pF GONTHACiO -0R AUIMORIZED AGENT / �/T4 <br /> 2313 Maple Street X �r,� �`)r�`�� � r� � . 10 22 8S <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET�TOILET) AIR COND.UNITS — H.P. E4. <br /> 6ATHTUB FEFRIGERATION UNITS— H.P. EA. <br /> LAVATORY�WASH BASIN) BOILERS — H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS— TONNAGE EA. _ <br /> KITCHEN SIN!(d DISP. FORCcD AIR SYSiEMS— B.T.U. M EA. <br /> _ DISHWASHER _ WALL HEATEflS— B.T.U. M <br /> � LAUNORY TRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES W 1SHER EVAPORATIVE COOLERS <br /> WATER HEAi1R CLOTHES ORVERS <br /> URINAI VENTII_A110N FAN r4- <br /> DRINKING FOUNTAIN FANGE HOOD � <br /> FLOOR DRAIN AIR HANDLING UNIT — C.F.M. f <br /> VACUl1M BREAKERS STOVE —WOOD � 5O �' <br /> ROOF DRAINS— RAINLEADERS ME7AL Fl(7EPLACE 8 CHIMNEY <br /> SINK(SERVICE — H�R, ETG) FIf7EPLACE INSEfl7 <br /> HEAT PUMP <br /> H H <br /> H '% <br /> ra : <br /> SUB TOTAL '+ SUB TOTAL 5 J 5O � �[[[��� <br /> PERMIT S PEIiM1T 5 �O OO � <br /> TOTAL FEE f TOTAL FEE S �] 5O y �� <br /> SIDE YARD aETBACK STREET SETBACK REAR VAFD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE O ': <br /> FEE RECEIPT N0. � � <br /> USE ZONE LO7 AREA VACANT SITE FEES VALUATION FEE �' <br /> �. :YES "-NO <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF DWELUNG UNITS y y <br /> C � <br /> H H� <br /> BUILDING S H U <br /> SITE OF fiLDG. NO.OF STOFIES MA%.OCQ LOAD K ':' <br /> PLUMBING O �- <br /> FIRE ZONE BASEMENT FIPE SPRINKLERS MECMANICAL �7 5O � �, <br /> REUUIRED <br /> �.�.Y ES NO �' <br /> APPNOVALS BY DATE OTHER �. <br /> u.e.c. r <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY SEC.303�a) F� <br /> 2.BUILDING PLANS � <br /> 3.FIREHYDFANT TOTAL �] 5� � <br /> 4.FIREPRO7ECTIONSYSTEM PERMITVALIDATION . � <br /> 5.GRADING WHEN PROPERLY VAUDATED(IN THIS,SpAC61 THIS IS YO�RPE�M1�R --Q'� K <br /> � i � � <br /> G.ORAINAGE Q ` <br /> c� <br /> L ENVIRONMENTAL161PALTSTATEMENT c <br /> I,i { " <br /> B.HEALTH�ISTRICT � 'r"� � <br /> APPLICATION ACC. BV PLANS CHECKED BY APPR. FORISSUANCE BY � <br /> ,_ r <br /> 6 <br /> � <br /> � <br /> — F <br /> I .. , [ <br /> ADDRESS Fl�f: - <br />