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CITY OF CgNSTRUCTION eve, ,�,_8810 PERMIT PERMITNQ1- 90`C� <br />� <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Gq MECHANICAL ❑ PLUMBIN'.-. ❑ SIGN <br />DINER MAIL ADDRESS CITY ZIP PHONE <br />Geraldine Matteson 2131 McDougall Everett, WA 98201 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHOUE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAR ADDRESS CITY ZIP PHONE LICENSE <br />G 6 S Heating Co, Inc. 500 E Main St Monroe, WA 98272 794-7306 GSHEACI147JD <br />MAIL ADDRESS <br />CITY ZIP <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR EJ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />f <br />Install new gas furnace hot water tank and gas line <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />single family residence <br />1 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 OF CONTRACTOR, AUTHORIZED AGENJ OR OWNER DATE <br />10/28/87 <br />LEGAL DESCRIPTION Or PROPERTY (SHOW BEI OW OR ATTACH FOUR COPIESI <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />2131 Nd McDougall <br />PLUMBING <br />NICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A:C - AHNDLG UNITS — H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P E1 <br />LAVATORY ( WASH BASIN) <br />BOILERS — 8. T.0 /H. P. <br />SHOWER <br />GAS FIRED A C. UNITS — B T.0 <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B T U M EA <br />O <br />DISHWASHER <br />WALL HEATERS — BTU. 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 />WgTER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOODS" OVE <br />SINK (SERVICE - BAR. ETC) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />f <br />SUB TOTAL <br />15 <br />50 <br />PERMIT <br />f <br />PERMIT <br />15 <br />TOTAL FEE <br />S <br />TOTAL FEE <br />30 <br />O <br />FRONT SETBACK <br />REAR SLTBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />30 <br />50 <br />FIRE SPRINKLERS REOUIRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />Sec. 304(c) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />MM <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE <br />BY <br />DRIVEWAY PERMIT <br />TOTAL <br />30 <br />50 <br />ecowr vu mAnnu <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />m <br />O <br />M <br />T— <br />ADDRESS FILE <br />J <br />