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TAW F.1 N'I)RIT'1•II <br />rug ,�I <br />everett <br />259-8745 <br />(`INSTRUCTION <br />PERMIT <br />PERMIT NQ: 1 8021 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL gPLUMBING ❑ SIGN <br />OWNER MAIL AOHIII sr: CITY ZIP PHONE <br />Glen Johnston 1724 Walnut Everett <br />ARCHITECT OR DESIGNER MAII ADORE ;5 CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADPRLSS <br />CITY <br />ZIP <br />PHONE LICENSE <br />Damage Repair Service <br />P.O. Box 2045 <br />Everett 98203 <br />337-4222 <br />DAHAG2238D3 <br />MECHANICAL CONTRACTOR <br />MAIL APDRFiS <br />CITY <br />ZIP <br />PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADPR[y5 CITY ZIP PHONE LICENSE• <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION FFl REPAIR O DEMOLITION ❑ BUILDING RELOCATION <br />rAI LOTION Or WORK <br />DESCRIBE WORK <br />Renew piping and set fixtures <br />HEAT SOURCE _ <br />❑ ELECTRICITY El GAS LI WOODSTOVE Ll OTHER <br />PROPOSED USE OF BULLDING <br />Residence <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 <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE P FORMANCE OF CONSTRUCTION. <br />5¢:NnT Uf - OR A IORIZED AGENT. ORO ER DATE <br />z -� <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR AT T AOI I OUR COPIES) <br />LOT — BLOCK — OF <br />Joe ADDRESS <br />Walnut1724 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />ic <br />OO <br />A'C- AMNDLG UNITS — HP <br />BATHTUB <br />5 <br />OO <br />REFRIGERATION UNITS — I -P. EA <br />LAVATORY (WASH BASIN) <br />10 <br />OO <br />BOILERS —B. T.U/H P. <br />SHOWER <br />GAS FIREDAC UNITS —BTU <br />KITCHEN SINK d DISP <br />S <br />OO <br />FORCED AIR SYSTEMS — B T U M EA <br />DISHWASHER <br />WALL HEATERS — B T U. _ M <br />LAUNDRY TRAY <br />UNIT HEATERS -- B T.0 _ M <br />CLOTHESWASHER <br />5 <br />OO <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />RANGE HOOD <br />WATER HEATER <br />G <br />50 <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK ISERVICL — BAR, ETC.) <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUB TOTAL <br />S <br />SUB TOTAL <br />G <br />50 <br />PERMIT <br />f <br />PERMIT <br />15 <br />OO <br />TOTALFEE <br />f 1r, <br />no <br />TOTALFEE <br />FRONT SETBACK <br />REAR SETBACK SIDESETBACK <br />PL AN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF OWELLINGONITS <br />PLUMBING <br />35 <br />00 <br />SIZE OF SLOG <br />NO OF STORIES <br />MA% OCC LOAD <br />MECHANICAL <br />50 <br />FIRE SPRINKLERS REOUIRED ❑ YES j NO <br />INVESTIGATION FEE <br />lel .cI <br />PK nrInAgum- <br />STATE BE SURCHARGE <br />STATE ENERGY SURCHARGE <br />tiam. rt <br />FL6u $'- <br />•� <br />APPLICATION ACC BY <br />S . H. <br />PLANS CHECKED BY <br />APMi rOB ISSUANCE❑1' <br />DRIVEWAY PERMIT <br />IDR 4,.1.` <br />TOTAL <br />y <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPAGCI I nIa IJ Tw.. r........ <br />r� <br />N <br />O <br />co <br />T_ <br />ADDRESS FILE <br />