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rlre fa'crcn•pn <br />everett <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 <br />4§:ONSTRUCTIO* <br />PERMIT PERMIT NO. 16231 <br />El COMBINATION $11] BUILDING ❑ MECHANICAL 1_] PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP "HONE <br />GFNE S. PRENTICE 1711 - 63rd Street Everett WA 98203 _ 148-946; <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Valley Natural Gas 11323 Highway 99 Everett WA 98204 355-7730 <br />MECHANICAL C014TRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />W NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />t <br />Install two hot water heaters <br />PROPOSED USE OF BUILDING <br />Residence <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 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 />SIGNATURE CONTRACTOR OR AUTHORIZED AO T DATE <br />X r /i ' 3/13/86 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT -BLOCK -OF <br />— <br />_ <br />JOB ADDRESS <br />1711 - 63rd 5i- S E ( <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 />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />6O1LERS — M.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />_ <br />HEAT PUMP <br />SUB TOTAL <br />S <br />SUB TOTAL S <br />9 <br />00 <br />PERMIT <br />S <br />PERMIT S <br />10 <br />00 <br />TOTAL FEE <br />S <br />TOTAL FEE $1 <br />19 <br />00 <br />SIDE YARD SETBACK <br />STNEET SETBACK <br />REAR YARD SETBACK <br />PLAN CHFCK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES (:NO <br />--- — <br />FEES <br />VALUATION <br />— <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />- <br />FAE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />f)YES 17NO <br />MECHANICAL <br />19 <br />00 <br />OTHER <br />^— <br />APPROVALS <br />BY <br />DATE <br />_ _ <br />1. ENVIRUNMENTAL CHECK LIST <br />PENALTY <br />U B.C. <br />SEC..303 pl <br />2. BUILDING PLANS <br />TOTAL <br />19 <br />00 <br />S. FIRE I/YDRANT <br />4. FINE PROTECTION SYSTEM <br />S.GRADING <br />PERMIT VALIDATION (� p7��'��1T� <br />WHEN PROPERLY VALIDATED (IN THISC G 9 SPACE THIS L4'JOII(jYP V UT_ Y <br />�� �J I %% �.`. <br />f(Y <br />, <br />i . r : C C I P 1 v ( <br />1 C U <br />8. DRAINAGE <br />7. ENVIRONMENTAL IMPACTSTATEMENT <br />S. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />1 7. UAt r (I <br />^.DURESS FILE <br />