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d�r£vrrerecn <br /> everett � ^ONSTRUCTION - <br /> ` PERMIT PERMIT NO. 1Z596 <br /> CITV HALL 259�87d5 <br /> EVERETT,WA98201 ❑ COMBINATION ❑ BUILDING �t MECHANICAL ❑ PLUMBING <br /> OWNEF MAIL ADDRE55 dTY ZIY PMONB <br /> Henry Carter 1718 Rockefeller Everett 98201 258-2910 <br /> P.RGMiiE.:T Ofl OESIGNEF MAIL ADDRE55 GTY ZIP PNONE <br /> GENERAL CONiqACiOP MAIL ADOPE55 CITY LIP PHONE LICENSE� <br /> Sr,me <br /> MECHANIGAL GONTRRCT09 MAIL AppRE55 GTY ZIP PHONE LICENSE 1 <br /> PLUMBING CONTRAGTOR MRIL AD�RESS CITV ZIP PNONE LIGENSE� <br /> CUSS OF WORN <br /> ❑NEW ❑ ADDITION CJ ALTERAiION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN �(WOOD STOVE/FIREPLACE INSERT <br /> VALUAfION OF WORK <br /> s <br /> OESCRIBE wORN <br /> install wood burning stove � <br /> PROPOSE�USE OF BUILDING py <br /> I HEREBY CERTIFY THAT I HAVc READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND •• <br /> LEGAL DESCRIPiION OF PNOPERTY�SNOW BELOW OR ATTACH FOUN COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> ior_e�ocK_oF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OF 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 y ,''",� <br /> LOCAL LAW REGULATING CONSTP.UCTION OR THE H � <br /> PERFORMANCE OFCONSTRUCTION. � <br /> J0�RDDRESS SIGNRTUR pF LONTRACTOR OR AUiHORIZEfI AGENT OATE � <br /> 1718 Rockafeller X �'� � 10/20/83 <br /> PLUMBING MECHANICA y <br /> O <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE � <br /> WATERCLOSET�iOILEn AIR COND.UNITS— H.P. EA. <br /> � OATHTUB REFflIGERATION UNITS— H.P. EA. � ~ <br /> Z <br /> LAVAfORY�WASM BASIN) 801LERS— M.P. EA. � <br /> SHOWER GAS FIRED A.C.UNIiS — TONNAGE EA. �y <br /> RITCHEN SINr'8 DISP. FORCEO AIR SYSTEMS— B.T.U. M EA. � �rrreee��� <br /> DISMWASHER WALL HEATERS— B.T.U. M � � <br /> LAUNDRY TRAY UNIT HEATERS— B.T.U. M M�1 <br /> CLOTMES WASHER EVAPORATIVE COOLERS y� <br /> WATEP NEATER CLOTHES DRYERS � ~ <br /> � <br /> URINAL VENTILATION FAN � <br /> �RI4KING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. N <br /> VACUUM BREAKERS 1 STOVE—WOOD � SO � <br /> ROOF DRAINS— RAINLEADERS METAL FIFEPLACE 8 CHIMNEY <br /> SINK�SERVICE— BAR. ETQ) FIREPLACE INSEfiT <br /> HEAi PUMP �y <br /> z <br /> � <br /> SUB TOTAL f SUB TOTAL S 7 50 N <br /> PEHMIT f PERM�T S <br /> TOTAI FEE S TOTAL FEE S 17 SO � <br /> i'� SIDE YAHD SEiBACK STREET SETBACK qEAF YARD SETBACK PLAN CMECK NUMBER PLAN CNECK FEE <br /> t FEE RECEIPL NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ".YES NO FEES VALUA710N FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OP DWELUNG UNITS <br /> ' BUILDING 5 <br /> 512E OF BLDG. NO.OF STOPIES M4%.OCC.LOAD <br /> PLUMBING <br /> I FIRE ZONE BASEMENT — FIRE SPRINKLERS MECMANICAL <br /> REOUIFED �.� SO <br /> VE� t10 <br /> APPPOVALS BY DATE OTHEfl <br /> 1.ENVIRONMENTAL CMECK LIST PENALTY U B.C. <br /> � SEC.70J lal <br /> I 2.6UILOING PLANS . <br /> 3.FIRE HYDRANT TOTAL 1'] SO <br /> i a.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> 5.GR�DING PoHEN PROPERL�VALIDATED�1N TMIb$qp�E)THI�I$�YQU91 f�EFj/�11T (n <br /> JJ L �) � � � �J s <br /> 6.DRAINAGE V 7 <br /> 7.ENVIRONMENTALIMPACTSTATEMENT �� <br /> 8.HEALTH DISTRICi � <br /> APPLICATION ACC. BY PLANS CMECNEO BY APPR.FOR ISSUANCE BV � ^� J I�. R�c..E I FT �'� <br /> �� ; i;�P!K 1'OU <br /> 'I ! C;,t �J <br /> ADDftESS PILE <br /> 1 <br />�� <br />