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The Ererxreen <br />CITY OF <br />everett <br />CITY HALL 259.8745 <br />EVERETT. WA 98201 <br />rONSTRUCTION <br />PERMIT PERMIT NO. 15574 <br />❑ COMBINATION ❑ BUILDING �jIX MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY LP PHONE <br />Terry Walsh 4316 South 3rd Everett 98203 252-3473 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY LIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />Same <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />Install woodburnina stoup <br />PROPOSED USE OF BUILDING <br />I 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 VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUR P CONTRACTOR ORRAnAUrHORIZEo AGENT UATE <br />X .( L..:_� �7" /14/85 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIE' <br />LOT -BLOCK -OF _ <br />__. <br />JOB ADDRESS <br />4316 South 3rd <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. I <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSETITOILET) <br />AIR COND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS - N.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS - B.T.U. M <br />_ <br />CLOTHESWASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />j CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />1 <br />STOVE - WOOD <br />7 <br />50 <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />SUBTOTAL S <br />7 <br />50 <br />PERMIT <br />S <br />PERMIT f <br />1. <br />TOTAL FEE <br />S <br />TOTAL FEE S1 <br />17 <br />50 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />!,YES _: NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />17 <br />SO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />17 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED ON THIS ffABE) THIj IUU YfLT )PtIT �} <br />Ln <br />\ �., E I P7 U) <br />YOU <br />5. GRADING <br />B. DRAINAGE <br />7. ENVIRONMENTAL IMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />I4OCT 85 <br />ADDRESS FII E <br />