Laserfiche WebLink
f1w Fvergrmn <br />CITY OC INSTRUCTION <br />everett PERMIT PERMIT NO. 20742 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ra MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY pip PHONE <br />Fredric Matheny 1310 Maryland Ave. Everett 252-9533 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY Zip PHONE <br />MAIL ADDRESS <br />CITY <br />PHONE LICENSE. <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />V Natural Gas Equip. 1625 E. Marine View Dr. 258-2441 NATURGE320N6 <br />PLUMPING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ERALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />Install gas boiler, water heater and range. <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME 1-0 BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCE' - <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 />THF. PER RMANC-: OF CONSTRUCTION. <br />SIGNATUR OF TOR. AUTHORIZED AGENT. OR OWNER CDATE <br />X �J Op <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />1310 Maryland Ave. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYP: OF EOUIPNENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - A,HNDLG UNITS - H P <br />BATHTUB <br />REFRIGERATION UNITS -- H R EA <br />LAVATORY (WASH BASIN) <br />1 <br />BOILERS — B.T.U./H.P. ion, O <br />SHOWER <br />GAS FIRED A.C. UNIT!, — B.T.U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS —8.T.0 M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.0 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 />1 <br />WATER HEATER <br />r� <br />ROOF DRAINS — RAINLEAOERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />1 <br />stove <br />SUBTOTAL <br />S <br />SUBTOTAL <br />PERMIT <br />f <br />PERMIT <br />TOTALFEE <br />S <br />TOTALFEE <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />_ <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />S <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF SLOG <br />NO OF STORIES <br />MAX OCC. LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REOUIRED ❑ YES ONO <br />INVESTIGATION FEE <br />SoC f'PI(p) <br />STATE BUILDING SURCHARGE <br />-TOML <br />STATE ENERGY SURCHARGE <br />CHECK $77.00 <br />APPLICATION ACC BY 11; CHECKED BY <br />APPR. FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />37 <br />00 <br />nPRWT VAI DAT!ON <br />WHEN PROPERLY VALIDATED ;IN THIS SPACE) THIS IS YOUR PERMIT <br />N <br />C�- <br />O <br />N <br />i <br />AD: T, .S r Ili <br />