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�he Ecrrg�cen <br />�„� o� <br />everett <br />CITY MALL 259�N7a5 <br />EVERETT. VJA 98201 <br />� CONS�'RUCTIO' � <br />PERMIT <br />❑ COMBINATION ❑ BUILDING �j(1 MECHANICAL <br />PERMIT NO. 12646 <br />❑ PLUMBING <br />QWHEq MAILADDRE55 CITY 21P PNONE <br />KAREN M. STEARNS 5510 S. 3�•d Ave Everett WA 98203 259-6374 <br />RNCMIiELT OR DESIGNER ���Il AD�RE55 CITY ZIP PNONE <br />GENEPALGONTRACTOR MAILd�DRESS CITY 21P PHONE LICENSE� <br />MECMRNIGI.L �ONTRRGTOF <br />b1AIL AOOPESS CITY ZIP PHONE LICENSE / <br />PLUMBING CONTRACTOR <br />MAIL ADDFE55 CIiY 21V VHOHE LIGENSE / <br />O NEW � ADDITIO� ❑ A�TERA710N ❑ REPAIR ❑ DEMOLITION O FENCE O SIGN XI'}J� WOOU STOVFJFIREPLACE INSERT <br />s <br />OESCRIBE WORN <br />Install wood stove <br />��y Singl�e family residence <br />EGRL DESCRIPTION OF PROPERTY �SHOW BEIOW OR <br />LOT _BLOCN __OF <br />,oaa��lOSSoeth 3rd <br />PIUMBING <br />NO. � iYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOILEn <br />BATHTUB <br />LAVATORY �WASH BASIN) <br />SHOWEH <br />KITCNEN SINK 8 DISP. <br />DISM W ASH ER <br />LAUNDPVTRAY <br />CLOTNES WASMER <br />WATER MEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VAGUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — PAR, ETC.) <br />TOTAL FEE <br />SIZE OF <br />APPROVALS <br />1. ENVIRONMENTAL CMECK L15T <br />2. BUILDING?LAMS <br />7. FIRE MYDRAN i <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. ORAINAGE <br />8. MEALTM <br />PLANS <br />� <br />f <br />S <br />REAR YARO 5 <br />VACANTSRE <br />'.�.YES �.�NO <br />NO. OF OWEL <br />MA%. OCC. L( <br />rIFE SPRINKI <br />REOUIRED <br />YES . NO <br />FOH <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAR4INED THIS <br />ApPLICATI0P1 AND KNOW THE SAME TO BE TRUF ANJ <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANC�=S <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WiTF' <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMI' DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />�R CANCEL THe PROVISIONS OF ANY OTHER STATE OH <br />LOCAL LAW REGULA7ING CONSTRUCTION OR TH[ <br />PERFOR ANCE OF CONSTRUCTION. <br />SIGNAjUIi F CONiRA�q R OR PUTM!��{IZED /G[YT �pT� <br />X-�j ��.ww`/%�%/JL't�Zc�vi.C� 11/2/83 <br />MECHANICAL <br />TYPE OF EQUIPMENT <br />AIR COND. UNITS — M.P. EA. <br />FEFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P EA. <br />GAS fIRED A.C. UNIiS — TONNAGE EA. <br />FORCED Alll SYSTEMS — B.T.U. M EA. <br />WALL HEATcRS — �.T.U. �� <br />UNIT NEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHO00 <br />AIR HAIIDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 GMIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP _ <br />Bl11LDING <br />�AD — <br />PLUMBING <br />.ERS MECHANICAL <br />DATE OTHER <br />PENALTY <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE S <br />PLAN CI <br />FEE <br />VALUATION <br />S <br />LLB.C. <br />SEC. 303 (al <br />RECEIPT NO. <br />FEE <br />TOTA� I / ) <br />PERMIT VALIOATION <br />WHEN PROPERLY VALIDATED QN THIS�S(�� TMiS � xOI�Rj'F{iA}�T _C[y <br />S� �) �� 7 � �l <br />C.� <br />N <br />'iOUR RECEIPTr+ <br />BY <br />-:;�,a�� ��ou <br />ADDRESS fil[ <br />- 3 �o� h 3 <br />� <br />