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F <br />CITY Oof CINSTRUCTION - everett PERMIT PERMIT NQ. - 20253 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑TL MECHANICAL '❑ PLUMBING El SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Robert W.Kelvy 5120 27th Ave W. Everett 98203 348-3780 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR N <br />PHONE <br />Valley Nat. Gas 11323 Hwy 99 Everett 98204 355-7730 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE II <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />Install furnace and water heater. <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />I HERBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Single family residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRIPTION OF PROPERTY (SF.OW BELOW OR ATTACH FOUR COPIES) <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT _BLOCK _ OF <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 />_ <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT E OF CO t AC -An. OTHORI I AGENT, OR OWNER DATy <br />rb/ <br />JOB AOORFSS <br />Ave <br />y' <br />X -� - <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 />A/C — A/HNDLG UNITS — H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — B.T.U./H. P. <br />SHOWER <br />GAS FIRED A C. UNITS — B.T.U. <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA.no <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS —BT.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DF AIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />_ <br />SINK (SERVICE — BAR. ETC.) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />I{I <br />f <br />_ <br />SUB TOTAL <br />S <br />SUB T T f <br />15 <br />50 <br />PERMIT <br />f <br />PER) f <br />500 <br />TOTALFEE <br />f <br />TOT <br />FRONT SETBACK <br />REAR SETBACK <br />_ <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FW�-f11»MECH <br />RErJCOEIPT NO. III <br />I <br />vA <br />#0=025J <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />TION $3 <br />_ <br />3.50 FEE <br />OYES ONO <br />BUILDING <br />,,,�yy(F�T(F��qq et <br />iTvw 0254 <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO. OF CWELLING UNI FS <br />PLUMBING <br />KM20257 <br />SIZE OF BLOG. <br />NO Of STORIES <br />MAX. OCC LOAD <br />MEC` $ <br />MECHANICAL <br />.�50 30 <br />INVES'OGATION FEE Sec. 3041e) <br />FIRE SPRINKLERS RECUIRED ❑ YES ❑ NO <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATIO14 ACC. BY PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />S.H. <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />M <br />Ln <br />N <br />O <br />N <br />ADDRESS FILE <br />