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Ih�� l�Tercrrcn <br />e�e�°eti <br />arv rin�� z,s-u7as <br />"ONSTR�.JCTIO(� <br />PERIVIIT <br />PERMIT N0. ! �:�'- �� <br />eveaErT. wn �ezai [] COMBINATION ❑ BUILDING X�'k MECHANICAL �� PLUMBING <br />OYlNEH 'dAIL AD�FE55 CRY ZIP PHONE <br />CLAUDE W. DALE 10601 - 9th Dr SE Everett WA 98204 348-4129 <br />FRCMRECi OR DESIGN[R lAFIL ADDFE55 GiTY ZIP PHONE <br />GENERAL C-0NTRfCiOH MAIL AppRE55 CITY 21P PMONE LICEHSE d <br />same <br />MECMANICAL CONiRACiOR MA1L nDDRESS CITY 21P PHONE LICENSF N <br />PLUMBiYG CONTRACiOR NAIL AODRESS CITY ZIP PF!ONE LICENSE X <br />❑ NEW ❑ ADDITION O AL7ERATION ❑ REPAIR ❑ DEMOlI710N O FENCE G SI:iN p' WOOD STOVEIFIREPLACE INSER7 <br />V4WATION OF WOfiK <br />5 <br />�ESLFIDE 1YORK <br />Install taood stove <br />PROPOSE� USE OF BUILDING <br />Residence <br />OR ATTFCH FOUR COPIES� <br />LOT__BLOCK_OF <br />10601 - 9th DR 5� Everett <br />PLUA181NG <br />NO. TYPE OF FIXTI <br />WA7ERCLOSEtQOI�En <br />BATHTUB <br />LAVATOHY(WASH BASIN) <br />SMOWER <br />KITCHEN SINK 8 OISP. <br />DISHWASHER <br />LAUNDFlYTRAV <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DPINK!NG FOUNTAIN <br />FLOOR DRAIN <br />VACUUAtBHEAKERS <br />ROOF DflAINc - RAINLEADERS <br />SINK (SERVICE - BAR, ETC.� <br />SUB TOTAL <br />PEFIMIT <br />70TALFEE <br />SIDE YAflD <br />S:ZE OF BLDG. I NO. <br />APPflOVALS <br />1. ENVIRONMENTFL CHECK LIST <br />2. 9UILDING PLANS <br />7. FIRE HYDRANT <br />4. FIRE PRO7ECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONIJ�ENTALIMPACTSTATEMENT <br />8. HEAL7H DISTRICT <br />�Y <br />stg <br />I HEREBY CERTIFY THAT I HAVE READ AIVD EXAMINED THIS <br />APPLICATION AND KNOW THE SAME l'O BE TRUE AND <br />CORR[CT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIEC HEREIN OR NOT. THE GRANTING OF A <br />PERM11IT DOES NOT PRESUh1E TO GIVE AUTFIORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY iJTHER STATE OR <br />LOCAL LA�V REGULATING CONSTRUCTION OR THE <br />PEAFORMANCE OF CONSTRUCTION. <br />sic'CaiIIRE OF CONiRACTOR OR1lN1�ORl]Ff] af.FNT pAiE <br />X �XEt. <br />MECHANICAL <br />� AIR COND. UNITS - H.P. EA. <br />HEFFIGERATION UNITS - H.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRFU A.C. UNITS - 70NNAGE EA. — <br />FOPf,cD AIR SYSTEMS - B.T.U. M EA. <br />JALL 'NEATERS - B.T.U. M <br />UNIT FIEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES URVERS <br />VENTILATIO� FAN <br />�— <br />RANGEHOOU <br />MR HANOLING UNIT - QEM1?. <br />1 S70VE - WOOD <br />ME7AL FIREPLACE 8 CHiMNEv <br />FIREPLACEINSEHT <br />HEAT PUMP <br />S <br />5 <br />5 <br />REAR YARD SET6ACK PLAN CHECK NU6 <br />VACAN7 SITE <br />�.!YES . NO FEES <br />1AA%. OCC. LOAD <br />FIRE SPHINKLERS <br />HEQUIRED <br />YES .NO <br />BY I DATE <br />BUILDING <br />PLUM5ING <br />MECHANICAL <br />OTHER <br />PENALTY <br />SUB 70TAL <br />PEFMIT <br />TOTALFEE <br />FEE <br />5 <br />1/8/86 <br />f-EE <br />5 / <br />S �.� <br />S; 17 <br />CHEGK FEE <br />RECEIPT NU. <br />VP!UATION I FEE <br />TOTAL 17 50 <br />PEFMI7 VALIDA710N <br />WHEN PROPERLY VAUDATED QN THIS SPACE) THIS S O q/PERM(�IT �:`: <br />� �� �� �� �i � � l. � 11 _." -.;;� <br />i;ri��_.. , ,. <br />�'�_' .. . <br />z <br />0 <br />� <br />n <br />m <br />.. .� <br />-i -ri <br />... -r <br />(n S <br />0 <br />m <br />co <br />mo <br />n <br />--i c <br />O � <br />fT� <br />-i z <br />2 -I <br />m <br />.. <br />O z <br />C <br />➢ —� <br />rx <br />.-� .� <br />--I � <br />� Ti <br />o � <br />TI D <br />-i fri <br />x <br />m � <br />v. <br />� <br />or <br />n f�� <br />cv <br />3 N <br />m <br />Z C% <br />—i r <br />m <br />� <br />� <br />� <br />_ <br />v. <br />C <br />�' <br />r- <br />