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everett � �NSTR����TION �� �`� <br /> 259 -8745 PERM�T PERMITNQ. ZU596 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MNILADDRESS CITY 21P PNONE <br /> 7bm Cook 4906 23rd Ave. W. �erett 96203 355-2373 <br /> AqLHITELTORDESiGNEfl MAILADUPESS CITY ZIP PHONE <br /> GENERAL CONiRPCTOR MAIL AODflE55 pTY ' ZIP PHUNc LICENSE• <br /> Valley Nat Gas 11323 Highway 99 Everett 98204 355-7730 VALLElVG153L2 <br /> MECHANICAL CONTRACTOR MAII hODRE55 CITY 21P PHONE L'CENSE x <br /> PLUMBINGCONTRACTOF MAILNDDFESS LITV ZIP PMONE IICENSEM <br /> CLASS OF WORK <br /> ❑ NEW ❑ ADDITION Q ALTEHATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> V/LUATION OF WORI( <br /> S <br /> DESCRIBE WORN ' <br /> Install nat. gas furnace and water heater. <br /> HEAT SOURCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> FflOPOSEU USE OF BUILOING <br /> Sin le famil residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> g y APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIPTIONOFPpOPERTV�SMOW�ELOWOHFTTACMFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �or_e�ocK _ oF_ WHETHER SPECIFIED FiEFE1N OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMc TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> � STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> � THE PERFORMANi.E OF CONSTRUCTION. <br /> JOB ADORESS SIGN/T E OF ONT CT R.A TMORIZE�AGENT.OR OWNER OATE <br /> 4906 23rd AVe. W. X `� ' � <br /> � PWMBING 61ECHANICAL <br /> �� NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '.� WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. <br /> ' BATHTUB REFRIGERATIONUNITS—H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS—B.T.0/H.P. <br /> ' SHOWER GAgFIREDA.C.UNITS—B.T.U. <br /> . , KITCHEN SINK d DISP. 1 FORCED AIR SVSTEMS—B T.U. M EA. 9 OO <br /> DISHWASHER WALLHEATERS—B.LLL M _ <br /> � LAUNDRY TRAV UNIT HEATERS—B T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> ?��- , URINAL CLOTHESDRYERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> � FLOOR DRAIN RFNGE HOOD <br /> � BACKFLOW PREVENTERS 1 WATER HEATER Fi SO <br /> ROOF DRAINS—RAINLEADERS �NOO�STOVE <br /> . SINK(SEflVICE—BAR.ETC,) METAL FIREPLACE 8 CHIMNEV <br /> - FIREPLACE INSEfiT <br /> HEAT PUMP <br /> Z GASPIFING <br /> � E%HAUSTFAN <br /> SUB TOTAL 5 SUB TOTAL ZS SO <br /> PERMIT S PERMIT ZS OO <br /> TOTAL FEE S TOTAL FEE 30 SO <br /> FRONTSETBACK REARSETBACN SIOESETBACK PLANCHECKNUMBER FEE RECEIPTNO. <br /> USEZONE LOTAREA yqCANTSITE ^ M <br /> ❑ves ❑No FEES A 0 _ <br /> TYPEOFCONST. OCCUPANCYGROUP NO.OPOWELLINGUIlITS BUILOING �{pp�pp596 <br /> PLUMBING �CH S . I <br /> SIZE OF BLDG N0.OF STORIES MA%.OGG LOAD � � I <br /> MECHANICAL 30 SC � <br /> INVESTIGATION FEE � Sec.304(e) �� <br /> i <br /> FIRE SPRINKLERS REOUIRED ❑YES ❑NO � <br /> --' STATE BUILUMG SURCHARGE <br /> STATEFNERGYSURCHARGE <br /> APPLICPTION ACC.HY PLANS CMECKED BY /PPR FOR ISSUFNCE OY <br /> DRIVEWAY PERMIT <br /> S.F3. TOTAL 30 50 <br /> PEPMIT V1ILIOATION I <br /> WHEN PFOPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> �� <br /> Q�� <br /> �� <br /> 0 <br /> N <br /> i ;_ �,c'.. .; I <br />