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theEiwvvm <br />CITY OF CINSTRUCTION <br />everett PERMIT <br />259-8745 <br />PERMITNQ:_ 20257 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING j7 MECHANICAL '❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />_ Walter Shafer 612 34th St. Everett 252-3014 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />CITY ZIP PHONE LICENSE / <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Valley Nat. Gas 11323 Hwy 99 Everett 98204 8 355-7730 VALLENC1571.1 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE II <br />❑ NEW ❑ ADDITION IKI ALTERATION ❑ REPAIR Cl DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />DESCRIBE WORK <br />Install forced air system, water heater, and gas Dining. <br />HEATSOURCE <br />Cl ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ 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 1'D 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 CONSTRUCTION OR <br />THE PERFORM CE OF CONSTRUCTION. <br />SIGNA RE OF T CT AU IODIZED AGENT. OR OWNER DA� <br />X40, <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _BLOCK OF <br />— <br />JOB ADDRESS <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 ABC. UNITS — B T.U. <br />_ <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS — 8.T.U. M EA. <br />" <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRVTRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS- <br />URINAL <br />CLOTHES DRYERS 06/97/88 1:11pm.� <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD M00020M <br />�.'. <br />BACKFLOW PREVENTERS <br />WATER HEATER HECH sm.SD <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE #090202% <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE 8 CHIMNENYECH $ <br />.50 <br />FIREPLACE INSERT N00020253 <br />HEAT PUMP TECH $1 <br />GAS PIPING N00020254 <br />EXHAUSTFAN HECH $21 <br />50 <br />#0W20257 <br />SUB TOTAL <br />f <br />SUB TWM <br />PERMIT <br />f <br />PERMIQHEM $143.50 <br />TOTALFEE <br />f <br />TOTALFEE <br />FRONT SETBACK <br />REARSETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITF. <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF GLDG N0. JF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />30 <br />50 <br />FIRE SPRINKLERS REQUIRED ❑ VES ❑ NO <br />INVESTIGATION FEE <br />Sec. 304(e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />S.H. <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />30 <br />50 <br />DPRmT VAI mennN <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />L�— <br />Ln <br />N <br />O <br />N <br />M. <br />