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`����' C�NSTRUCTION <br /> CITYOF �, �� �� <br /> everett PERMIT PERMITNO. 20��� <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILADDRE55 CITY ZIP PHONE <br /> Dr. Rolf Holle 5005 - 23rd Ave W. Everett, WA 98203 353-4942 <br /> ARCMITELT OR DESIGNER MAIL AUDPE55 QTY 21P PHONE <br /> GENERr1L CONTRACTOR MFIL ADORESS CITY 21P PMONE UCENSE x <br /> MECMANICRLGONTRRCTOR MAILAOORE55 CITY ZIP PHONE LICENSEM <br /> Valley Ite=fc�= Natural Gas 11323 Hwy 99 Everett, WA 98204 355-7730 VALLENG143LI <br /> PLUMBING CONTRACTOR MAII AODPE55 CITY ZIP PHONE LIGENSE� <br /> CL/SS Oi WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLf716C: ❑ BUILDING HELOCATION <br /> VAlUAT10N OF N'ORK <br /> S <br /> DESCFIBE WOFN <br /> Install furnace, pool boiler, water heater � <br /> MEAT SOURCE <br /> O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> PROPOSEDUSEOFBl11L01NG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Single family residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAlDESCRIPT'��)NOFPROPEFTY�SHOWBELOWORATTACHFOURCOPIESI CORRECT. ALL PROVISIONS OF LAWS AND OROINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE CUMPLIED WITH <br /> LOT_BLOCN _ OF WHETHE�' SPECIFIEU HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHOR{TY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> JOf AOORESS SIGNATl1Pji OF CON P T .AU MORIZEU AGENT.ON OWNER DAiE <br /> V��` 9/19/88 <br /> 5005 23rd Ave W. X ��.d� <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C-�A/HNDLG UNITS—H.P. <br /> BATHTUB REFRIGEFATION UNITS—H.V.EA. <br /> LAVATORV(WASH BASIN) 1 BOILERS—B T.UIH.P. 16 SO <br /> SHOWER 1 GASFIREDA�C.UNITti—B.T.U. B SO <br /> KITCHEN SINK 8 UISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALLHEATERS—BT.U. M _ <br /> LAUNDRVTPAY UNITHEATEFlS—BT.U. M <br /> CLOTHES W4SHER <br /> E��APORATIVE COOLERS <br /> URINAL CLOTHES DF7YERS <br /> �RINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN FANGE HOOD <br /> BACKFLOW PREVENTERS 1 WATER HEATEfi <br /> ROOF DRAINS—(7AINLEADERS WOOD STOVE <br /> SINK(SERVICE—BAR.ETCJ METAL FIREPLACE 8 CHIMNEY <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> X GAS PIPING <br /> EXHAUSTFAN <br /> SUB TOTAL S SUB TOTAL 32 SO <br /> PERMIT S PERMIT I.S OO <br /> TOTAL FEE S TOTAL FEE 47 SO <br /> FRONT SETBNCN REAR SETBACK SIDE SETBACN PLAN CHECK NUMBER FEE RECEIPT NO. <br /> �X <br /> USEZONE ��TA�EA VACANTSITE <br /> ❑ves ❑r+o FEES VALUATION FEE <br /> TYPEOFCONST. OCCUPANLYGROUP NOOFOWEIIINGUNITS BUILDING � <br /> PLUMBING ��S9I� 11� ����� '�* <br /> 512E OF BLDG. NO.OF STORIES MF%.OCC.�OAD <br /> MECHANIf,AL ��t� 4 H&7[XXXXX��� 4�.SC� I <br /> INVESTIGIITION FEE �.304�e) �F .� i <br /> FIRESPRINKLERSREOUIRED ❑YES ❑NO STATE BUILDING SURCHARGE ` I <br /> STATEENERGYSURCHARGE <br /> APPUCATION ACC.BY PLFNS CNECNED BY APPR FOR ISSUANCE DY <br /> DRIVEWAV PERMIT <br /> I3.M. <br /> TOTAL 47 50 <br /> PEHMIT VALIDATION <br /> WHEN PROPERLY VALIDATEO�IN THIS SPACE)THIS IS YOUR PERMIT �. <br /> Q�� <br /> �..�� <br /> � <br /> N <br /> i,i),-;,�s_ : .. <br /> i- <br />