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7AP (:YCPR <br />CITYOF - COP'STRUCTION <br />CITY <br />everett PERMIT PERMIT NO.08502 <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS ..II. iu' I'H@Hl <br />Terry R. Chism 619 61st Street 98203 353-4157 <br />ARCHITECT OR DESIGNER MALL ADDRESS CITY ZIP PHONE <br />QENEFIN CONTRACTOR MAIL ADDRESS CRY ZIP PHONE LICENSE IFSame <br />MECHANICAL CONTRACTOR MAIL ADDRESS CRY ZIP PHONE LICENSE IF <br />PLUMBING CONTRACTOR MAIL ADDRESS CRY ZIP PHONE LICENSE 1 <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑OAMDE <br />VALUATION OF WORK <br />T <br />DESCRIBE WORK <br />instal wood burning heater <br />PROPOSED USE OF BUILDING <br />single family residence IHEREBY CERTIFY THAT IHAVE READ AND EXAMINED THIS AP - <br />TRUE AND CORRECT <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTA('H FOUR COPIES) <br />PLICATION AND KNOW THE SAME I BE <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT RLOCK_OF <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AU THORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTI OR ER RMANCE OF CONSTRUCTION. <br />SIGNAT TRACT T AGENT OAR <br />JOB ADDRESS <br />619 61st Street <br />10 / 2 9 / 8 0 <br />PLUMBING <br />MECHAN <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR CORD. UNITS — H P, EA <br />BATP.TUS <br />REFRIGERATION UNITS — M.P. EA <br />LAVATORY ASH BASIN <br />BOILERS — II.P. EA, <br />SHOWER <br />GAS FIRED AC. UNITS — TONNAGE EA. <br />KITCHEN SINK 6 DISP. <br />FORCED AIR SYSTEMS — B.T.0 M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />__.. <br />u.IT MPATGRS -RT II N1 <br />HEATER <br />d <br />PERMIT <br />SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO <br />LOT AREA VACANT SITE <br />❑YES ONO FEES VALUATION FEE <br />INST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br />BUILDING 6 <br />1R NO. OF STORIES MAX. DOC. LOAD <br />FIRE ZONE BAstmtrvl ^m'r^'^^"^' MECHANICAL <br />REOUIRED _ 7 15 <br />It. ENVIRONMENTAL CHECK LIST <br />— <br />PENALTY <br />U B C <br />303 Iel <br />2. BUILDING PLANS <br />TOTAL <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIJATEU NN THIS SPACE) THIS IS YOUR PERMIT <br />9 8 0 1 C E O 0 7. 5 0— cc . <br />=.7I1' <br />L0 <br />00 <br />'.'' _, I I R RECEIPT o <br />NK YOU <br />S. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />v.c. <br />