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(he£verR�� ,i �ONSTRUCT1011� � <br /> CiTY OF <br /> everett PERMIT PERMIT NO. 16479 <br /> qTV HALL 259-87�5 <br /> EVERETT,WA 98201 � COMBINATION ❑ BUILDING 0 MECHANICAL ❑ PLUMBINCi <br /> OWNEfl M, .ADDRE55 CITY ZIP PHONE <br /> I�ITH GILLILAND 10405 - 3rd Ave cE F�r fr wa aa�ne asi S�S(� <br /> ARCXITECT OR DESIGNER M�'L/�DRESS CITY ZIP PMONE <br /> GENERAL CONTR�CTOR MRIL AODRESS CITY llP PMONE LICENSE I <br /> $BIIIE <br /> MECXANICAL CCNTRACTOR MAIL RO�RESS CITY ZIP PHONE LICENSE I <br /> PLUMBING GONTR�CTOfl MRIL ADORE55 GITY ZIP PHONE UCENSE� <br /> CLASS OF WORIt <br /> O NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOlITION ❑ FE�'�E ❑ SIGN � WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> i <br /> DESCPIBE WOPK <br /> Install wood stove <br /> PROPOSEO USE OF flUILPING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGA�DESGRIPTION OF PROPERTY(SHOW BEIOW OR ATTRCM FOUR COPIES� APPLICATION AND KNOW THE SAME Tq BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS f,ND ORDINANCES <br /> LOi_BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB AOORE55 SIGNI.tUR OF C TPACTO�i OR U Ri2E ENT DATE <br /> 10405 - 3rd Ave SE X � 4/28/86 <br /> PLUMBINO MECMANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�LOILEn AIR COND.UNITS — H.P.EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> LAVATORY�WASHBASIN) BOILERS — H.P.EA. <br /> SHOWER GAS FIRED A.C.6.11T5— TONNAGE EA. <br /> KITCHEN SINK 8 OISP. FORCED FIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> �AUNDRV TRAY UNIT HEATERS— B.T.U. M <br /> CLOTMES WASMER EVAPORATIVE COOLERS <br /> WATER MEATER CLJTHES DRYERS <br /> URINAL YENTILATION FAN <br /> ORINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING 11Nli— C.F.M. <br /> VACUUM BREAKERS 1 STOVE —WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR, ETQ) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAI f SUB TOTAL S <br /> PEHMIT f PENMIT S <br /> TOTAL FEE f TOTAL FEE f <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FE[ <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> '. YES . NO FEES VALUA710N FEE <br /> TYPE OF I:ONST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STOFIES MA%.OCC. LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL 1 SO <br /> REOUIRED <br /> YES NO <br /> APPHOVALS BY OATE �TMER <br /> 1.ENVIRONMENTA�CHECN l iST PENA�T� U.9 C <br /> — SEC.303 lal <br /> 2.BUILDING PLANS <br /> 7.FIRE MYDRANT TOTAL <br /> 1.FIRE PROTECTION SYSTeM PEPMIT VALIDATION <br /> 5.GRADING WMEN PROPERLY VALIDATEO�IN THI$L°AC�E�THIS 19 YOU(i BERMI` A <br /> 6.DRAINAGE I / , —�'` ` <br /> 7.ENVIRONMENTAL IMPACT STATEMENT � <br /> B.HEALTMDISTRICT � ' � �;- �'- __� <br /> APPLICATION ACC.BY PLANS CHECKED BV APPR.FOR ISSUANCE BV <br /> . . ' I <br /> i . <br /> , �.i 'i� l 'J <br /> ADDRES$ FILE <br />