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;I:, /I, I. .f'I <br />everett <br />CITY MALL 2598745 <br />EVERETT. WA 98201 <br />^OBSTRUCTION' <br />PERMIT <br />PERm;1 No. 15408 <br />[) COMBINATION a BUILDING MECHANICAL PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Greg S. Prentice 1709 63rd Street Everett 668-9502 <br />ARCHITECT OR DESIGNER MAIL ADDRESS C17Y ZIP PHONE <br />OEN RAL CON RACTOR <br />MECHANICAL CONTRACTOR <br />Valley Natural Gas <br />MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />MAL ADDRESS CITY ZIP PHONE LICENSE I <br />519 S.E. Everett Mall Way Everett 96204 355-7730 <br />PHnNF LICENSE F <br />CLASS OF WORN <br />❑ NEW ❑ADDITION O ALTERATION O REPAIR ❑DEMOLITION O FENCE ❑SIGN 0 WOOD 6TOVEIFIREPLACE INSERT <br />Install gas piping water Beater <br />and rurnace <br />PROPOSED USE OF BUILDING <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 />LEGAL DESCRIPTION OF PROPERTY )SHOW BELOW OR ATTACH FOUR COPIES) <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT _BLOCK —OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNAL RE F GONTRACTO R AUTHORIZED AGENT DATE <br />909D8E <br />JOB ADDRESS <br />1709 63rd Street <br />X <br />PLUMBING <br />MEC <br />NICAL <br />N0. TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />AIRRIGER UNITS N.P. EA. <br />N <br />REFRIGERATION UNITS — H.P. EA. <br />_ <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />_ <br />SHOWER <br />SINK d DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />6 <br />00_ <br />KITCHEN <br />WALL HEATERS — B.T.U. M <br />DISHWASHER <br />UNIT HEATERS — B.T.U. M <br />LAUNDRY TnAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />WATER HEATER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />_ <br />VACUUM BREAKERS <br />STOVE — WOOD <br />METAL FIREPLACE d CHIMNEY <br />ROOF GRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />MEAT PUMP <br />Pi in <br />2 <br />00 <br />Water Heater <br />4 <br />50 <br />f <br />SUBTOTAL f <br />SUB TOTAL <br />PERMIT f 0 <br />PERMIT <br />f <br />TOTAL FEE f 22 SO <br />TOTAL FEE <br />SIDE YARD SETBACK STREET SETBACK <br />f <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />RECEIPT NO. <br />FEE <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />';YES NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG, <br />NO. OF STORIES <br />MAK. OCC. LOAD <br />PLUMBING <br />FIRE ZONE BASEMENT <br />FIRE 6PRINKLERB <br />REQUIRED <br />MECHANICAL <br />22 <br />SO <br />_ <br />YES NO <br />APPROVALS <br />BY DATE <br />OTHER <br />U.B.C. <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC. 3071BI <br />_. <br />2. BUILDING PLANS <br />TOTAL 22 50 <br />PERMIT VALIDATION <br />jV2,a I5�y <br />WHEN PROPERLY VALIDATED (IN TH )7HI uL' .V�It- <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />5. GRADING <br />[9FI� <br />d <br />YOUR R [ C G I PT <br />S. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />THANK Y O U <br />APPLICATION ACC. BY <br />I PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />z <br />O <br />-H <br />0 <br />m <br />I -n <br />�m <br />7xn <br />mm 0 � <br />o� <br />�z <br />m <br />-H <br />o z <br />a -H <br />rx <br />M F. <br />K N <br />AT <br />T <br />-i <br />rxn . <br />p N <br />0 7- <br />nm <br />3 vN+ <br />-zI r <br />m <br />a <br />- `I JO- Ol <br />ADDRESS FIIE <br />