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s'awCITY '"F `ONSTRUCTIONg <br />everett PERMIT PERMIT NO. 17286 <br />259-8745 <br />DEMOLMON ❑ COMMINATION ❑ SWLDING ❑ MECHANICAL ❑ PLUMMNG O SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Skotdal Ent. P.O. Box 5267 Everett, WA 98206 259-4354 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PI <br />GENERAL CONTRACTOR MAIL ADORES; CITY ZIP PHONE LICENSE II <br />Self <br />MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE• <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION LI REPAIR ® DEMOLITION I] BUILDING RELOCATION <br />Tear down house <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE <br />❑ OTHER <br />PROPOSED USE Of BUILDING <br />Single family residence <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 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 CONSTFYJCTION OR <br />THE PERFORMANCE OF CONST JeTION. <br />SIGNATUR CONIT THORIZE0 DATE <br />X 10/8/86 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH TO' IR COPIESI <br />LOT 13-- 161-OCK 767 OF Plat of Everett <br />JOB ADDRESS <br />iia9xxx21zi 1611 - 33rd St. <br />PLUMBING <br />ME HANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />ABC — 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 A DISP <br />FORCED AIR SYSTEMS — B T U M EA <br />DISHWASHER <br />WALL HEATERS — BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHESDRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC I <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSFRT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />f <br />SUB TOTAL <br />PERMIT <br />f <br />PERMIT <br />TOTAL FEE <br />$1 <br />TOTAL FEE 11 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />I"EE <br />RECEIPT NO <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑No <br />FEES <br />VALUATION <br />FEE <br />BURRING <br />S <br />-Q <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLINGUN ITS <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />— <br />FIRE SPRINKLERS REOUIRED DYES LINO <br />INVESTIGATION FEE <br />Sec 304(e) <br />STATE BUILDING SURCHARGE <br />1 <br />SO <br />STATE ENERGY SUHCHARGF <br />APPLICATION ACC BY <br />M. M. <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />1 <br />50 <br />RCnMIT vAl InATION <br />WHEN PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT <br />CID <br />00 <br />n1 <br />I` <br />r� <br />