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- -, <br /> 1hrErrrAreen �O STRUCTIO <br /> �• � <br /> everett I PERMII� ( PERMITNO. �-�! � � , <br /> CITY HALL 259�8745 <br /> eveaerr,wn oezoi � COMBINAPON ❑ BUILDING �( MECHANICAL ❑ PLUMBING <br /> OWNER MAIL ApORE55 CITY <br /> ZIP PMONE <br /> NURMI 1511 Rucker Fvarntt wA qq�p� �For3820 <br /> ARCMrtECt OP OESiGNER MAIL q00RE55 LITY ZIP PMONE <br /> GE IEHqL COryJq,9CTOR MnIL qDDR[SS �. iY ZiP P✓ONE LiC[NSE• <br /> Va11ey Natural Gas 519 SE Everett Mall Way Ev?r_ett_41A-355�_30 <br /> IAECNANIC4L CONiqACTOR MPIL AD�RE55 CRV ZIP PHONE UCENSC� <br /> PLUMBING CONTRACTON MAIL AUOBESS �ITY ZiP PMONE LICENSE� <br /> GLA55 OF IYORN " <br /> ❑NEW � ADDITION Xli] qLTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVEJFIREPLACE INSEFT <br /> n <br /> VALUATION OP WORK <br /> S <br /> OESCRIOE WORK <br /> Replace gas furnace with same - install as hot k�*or heater <br /> racvosco use oF ewiou+c — <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> L[GALDESC91PilONOFPROPERTY�SMOWBELOWORATTPCNFOURCOPiES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES Z <br /> LOT_BIOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH o <br /> WHETHEF SPECIFIED HEREIN OR NOT.THE GRANTING OF A � <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE m <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR •• <br /> LOCAL L.AW REGULATING CONSTRUCTION Ofl THE <br /> PERFO ANCE OF CONSTRUCT��1tt''+11 .• <br /> JOB A�ORE55 SIGNAT . F COyIN �p � Ni pATE ,:,� .n <br /> 1511 Rucker X ,�� �� � , � <br /> PLUMBING M HANICAL ��" o m <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. ?YP EOUIPMENT FEE m o <br /> W ATER CLOSET�TOIIEn n <br /> AIR CONO.UNRS– H.R EA. .� C <br /> BATHTUB REFRIGERATION UNITS– M.P.EA. �m <br /> LAVATORY�WASM BASIN� BOILER$ – NP. EA. _ ..Z.� <br /> SHOWEfl GAS FIRED A.C. UNITS–TONNAGE EA. 6 OO m "" <br /> KITCNEN SINK 8 DISP. FORCEG AIR SVSTEMS– B.T.U. M EA. �C � <br /> DISNWASMEP 1NALL HEATERS– B.T.U. M r= <br /> .--� <br /> LAUNDFY TRAY UNIT NE4TERS– B.T.U. M � {n <br /> < <br /> CIOTNES WASHER EVAPORATIVE COOLERS -r� <br /> O A <br /> WATER MEATER CLOTMES DRVERS -n D <br /> URINAL VENTILATION FAN <br /> --� 'm <br /> x <br /> DRINKING FOUNTAIN RANGE HOOD m .. <br /> FLOOR ORAIN AIR HANDLING UNIT– C.F.M. p N <br /> or <br /> tlACUUM BREAKERS STOVE –WOOD n m <br /> ROOF DRAINS– HAINLEADERS METFL FIREPLACE&CHIMNEV � fNii <br /> SINK(SERVICE – BAR, ETC.) FIREPLACE INSERT Z n <br /> HEAT PUMP � i j <br /> a er�eater 4 50 A <br /> � <br /> 10 50 n <br /> SUB TOTAL f SUB TOTAL = �O OO � <br /> PERMIT S PF.qM1T f ZO SO = <br /> TOTAL FEE S TOTAL FEE f XX XX � <br /> SIDE VAR7 SETDACK STREET SETBACK REAR VAFD SETBACK PLAN CHECK NUM6ER PLAN CHECK FCE Z <br /> FEE RECEIPT NO. � <br /> � <br /> USE ZONE LOT Afl[A VACANT SITE " <br /> . VES NO FEES VALUAT�ON FEE m <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING 5 <br /> SIZE OF BjDG. NO.OF STORIES MAX. OCG LOAD <br /> PLUMBING <br /> a PIRE ZONE BASEMENT FiRE SPRINKLERS MECHANICAL ZO SO <br /> REOUIREO <br /> VES NO <br /> APPROVALS BY OATE OTHER <br /> 1. ENVIRONMENTAL CNECK LIST U B C. <br /> PENAL7V SEC.303�a� <br /> 2.BUILDING PLANS <br /> J.FIREHVORANT TOTAL ZO SO <br /> d.FIRE PROTECTION SVSTEM PERMIT VALIDATION <br /> 5.GRAOING WHEN P(IOPEflLY VALIDAiEO�IN THI�$PACE)THIS IS YOUP PEfiMIT___ �Y� <br /> 6.DRAINAGE ` ` ' � �� (Y1� <br /> Z ENVIRONMENTAL�MPACT STATEMENT �–� <br /> ' B.MEALTMDISTRICT �� <br /> APPLICAiION ACC.BY PLANS CHECKED BV APPR.FOR ISSUANCE BY ' ' ' � � <br />