Laserfiche WebLink
"eCINSTRUCTION Cc <br />everett PERMIT PERMIT NO. 9166 259-8745 <br />El DEMOLITION ❑ COMBINATION El BUILDING )® MECHANICAL ❑ PLUMBING El SIGN <br />ZIP <br />OWNER <br />MAIL ADDRESS CITY <br />Douglas Zander 5132 27th Ave W Everett, WA 98204 347-33 <br />80 ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE II <br />MAIL ADORES $ CITY ZIP <br />MECHANICAL CONTRACTOR PHONE LICENSE II <br />Valley Natural Gas 11323 Hwy 99 Everett, WA 98204 355-7730 VALLENGI LT PHONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />CLASS OF WORK <br />❑ NEW El ADDITION El ALTERATION ❑ REPAIR ❑ DEMOLITION ❑BUILDING RELOCATION <br />f 900.00 <br />IESCRIBE WORK <br />Install conv. burner / install water heater <br />TEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />Single family residence <br />cool nFRCRIPTION OF PROPERTY (SHOW BEL <br />LOT _ BLOCK _ OF <br />5132 - 27th Ave W <br />PLUMBING <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASII BASIN' <br />SHOWER <br />KITCHEN SINK A DISP. <br />DISHWASHER <br />LAUNDRYTRAY _ <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF DRAINS — HAINI <br />SINK (SERVICE — BAR. <br />Fl: <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 SPECIFI'D 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 PERFORMANCE OF CONSTRUCTION. <br />........ AUTHORIZED AGENT. OR OWNER DATE <br />X <br />MECHANICAL <br />FEE <br />NO. TYPE OF EQUIPMENT <br />A/C — A/HNDLG UNITS — H.P. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS —BT,U/H. P. <br />GAS FIRED A C. UNITS—B.T.U. <br />1 <br />FORCED AIR SYSTEMS —BT.U. MEA. <br />WALL HEATERS — B T.U. M <br />c� <br />UNIT HEATERS—E.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />1 <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSER'i <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />SUBTOTAL f <br />ocoulr f PERMIT <br />. HNII. <br />USE ZONE LOT ARIA VACANT SITE <br />❑YES ❑NO <br />TYPE OF CONST OCCUPANCY GROUP NO OF DWELLING UNITS <br />SIZE OF BLDG NO OF STORIES Max OCC LOAD <br />FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO <br />APPLICATION ACC BY PLANS CHECKED BY APPR FOR ISSUANCE B° <br />M. M. <br />rcc <br />FEES <br />p� <br />VALUATION... <br />FEE -- <br />BUILDING <br />$ <br />PLUMBING <br />30 <br />50 <br />MECHANICAL <br />INVESTIGATION FEE <br />Sec. 304(e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />DRIVEWAY PERMIT <br />30 50 <br />TOTAL <br />PERMIT VALIDATION <br />(IN THIS SPACE) THIS IS YOUR PERMIT <br />WHEN PROPERLY VALIDATED <br />C I <br />Co <br />r <br />Qm <br />r <br />/IOU i iLE <br />