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meawmven CITY OF F - CINSTRUCTION everett PERMIT PERMIT NO. 20250 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING xg MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Sarita Rodenhizer 2111 McDougall Everett 98201 258-1079 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE IICENSE• <br />Oozy Htg. 20221 67th Ave. NE Arlington 98223 435-4054 COZYHD*137NC <br />PLUMBING CONTFACTOR MAIL ADDRESS CITY ZW PHONE LICENSE <br />❑ NEW U ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />INi.YNIDBNB.RN:l3 <br />Install gas water heater, range and dryer. <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Single HUIV family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APFLICATION AND KNOW THE SAME TO BE TRUE AND <br />CCRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. TFE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIW7 AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONo OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMA14CE OF CONSTR CTION. <br />SIGNOT�'UR�V,OF CONTRACTOR. AUTIi0111 D NT. OR OWNER DATE <br />x LV� M , & _ 8 <br />LLUAL DESCHIPNON Ur PROPERTY (SHOW BELOW OR ATTACH FOUR CLINES) <br />LOT _ BLOCK _ OF <br />_ <br />JOBADDRESS <br />2111 McDougal <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />I TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - A/HNDLG UNITS - H P <br />BATHTUB <br />REFRIGERATION UNITS - 11 P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS - B T.U./H.R <br />SHOWER <br />CAS FIRED AC UNITS -8T.0 <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS - B T.U. M EA <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNDRY TRAY <br />UNITHEATERS - B T.0 M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />1 <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOV PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <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 />SUB TOTAL <br />$ <br />SUB T n <br />PERMIT <br />S <br />PER!!IfgWn <br />15 <br />00 <br />TOTALFEE <br />$ <br />TOTA n.i,, S <br />jQ <br />jO <br />FRONT SETBACK <br />REAR SETRACK <br />SIRE SEIRACK <br />PLAN CHECK NUMBER <br />FWCH 11 <br />000020248 <br />A6CE IPT NO <br />4 ill <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑NO <br />FEES <br />WWATION <br />_ <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />CHECK $l <br />7.00 <br />_ <br />SIZE OF BLOC, <br />NO OF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />34 <br />50 <br />FIRE SPRINKLERS REQUIRED CI YES ❑ NO <br />INVESTIGATION FEE <br />Sec 304(e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATIONACC BY <br />S.H. <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />34 <br />50 <br />ncnmt... In u <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />In <br />N <br />O <br />N <br />ADDRESS FILE <br />