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d��• c��•,L.�•e,� <br />%n r G� <br />everett <br />GTY HALL 259�B7d5 <br />EVERETT.�YF 98201 <br />^,ONSTRUCTION <br />PERMIT <br />❑ COMBINATION ❑ BUILDING I�t MECHANICAL <br />PERMIT NO. 138g�U <br />❑ PLUM8ING <br />owr�er+ IAAIL ADDFEJS "" 98201 252-0204 <br />Michael R. Cross ].209 35�h Everett <br />FRGMiTEGT OR OESIGNER <br />MAIL FDDRE55 CITY I�p PHONE <br />GB�ERAL CONTRFCiOR <br />MRIL /DORESS CITT ZIP PHONE LICENSE � <br />MECHANIGALGONTFAGTOF <br />h1ALL AOORE55 CITY ZIP PHONE LICENSE � <br />Same <br />PLUMBING CONTRALTOR <br />MAIL F�DRE55 ��T� ZiP PHONE LICENSE M <br />S <br />❑ NEW ❑�1U�ITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SI(iN iS� WOOD STOVFJFIREPLACE INSERT <br />Install wood burning stove <br />Single Family Residence <br />LEGRL DESCRIPTION OF PROPEflTY �SHOW BELO\N OR ATTAGH FOUR <br />E i�0' 15 e�ocK 826 oF Everett Div. H <br />an3-T6 <br />1209 35th Street <br />PLUMBING <br />NO. TYPE OF FIXT <br />W ATER CLOSET (TOI LET <br />BATHTUB <br />LAVATORY�WASHBASI <br />SHOWER <br />KITCHEN SINNB DISP. <br />DISHWASHER <br />LAUNDRYTflAY <br />OR ITEM <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR, I_TC.1 <br />SUB TOTAL <br />PEflMIT <br />TOTALFEE <br />1. ENVIRONtdENTAL CMECK LIST <br />2. BUILDING PLANS _ <br />�. FIRE MYDRAIJT <br />4. FIRE PRO7ECTiON SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B.HEALTH DISTRICT <br />eoai �CA710N ACC. BY PLANS CNE <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 AUTHOHITY TO VIOLATE <br />OR CANCEL THF PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULAT�NG CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. oATE <br />cir.ueriiac nF CONTPACTOR OR AUTNO�IZEO AGENT <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. _ <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FOflCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. h� <br />EVAPORATIVE COOLERS <br />CLOTMES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />1 METAL FIREPLACE 8 CHIMNEY <br />FIREPLaCEINSERT <br />HEAT PUMP <br />� <br />5 <br />5 <br />REAR VARD SETB <br />VACANT SITE <br />YES NO <br />NO. OF DWELLIN <br />MAX. OCC. LOAD <br />FIRE SPRINKLEf7 <br />REOUIRED <br />YES NO <br />BY OA <br />APPR. fOR <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />SUB TOTAL <br />PEflMI� <br />TOTAL FEE <br />F <br />FEE <br />VALUA710N <br />5 <br />9031a1 <br />FEE <br />5 7 S <br />S <br />S 1% 5� <br />CHECKPEE <br />RECEIPT NO. <br />FEE <br />17 50 <br />l% 5� <br />TOTAL <br />PERMIT VALIDATION : <br />WNEN PROPEf7LV VALIDATED pN THIS SPACE� THIS IS Y UR P�ERMIT _ � fx <br />? P�.:. , <br />l'! <br />. � _.� <br />BV <br />� <br />:'�.I`I)�Fqc .'nr: <br />