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7"', <br />I,If <br />'JahONSTR U CTIO N <br />everett <br />PERMIT <br />CITY HALL 259 8745 <br />PERMIT NO. <br />11304 <br />EVERETT, WA 96201 <br />❑ COMBINATION U BUILDING ! a"xMECHANICAL <br />LJ PLUMBING <br />OWNER <br />-- <br />MAIL ADORES:. <br />John R. Thiebaud 2007 63rd Street <br />AFICHI7ELT OR DESIGNCR Everett <br />Z <br />98203 <br />PHONE <br />355-6040 <br />MAIL ADDRESS CITY <br />21P <br />HONE <br />GENEFIALCONTRACiOR <br />MAIL ADDRESS CRY <br />Same <br />21P <br />PHONE LICENSEF <br />MECHANICFd Mutourno <br />-- r,...nc LICENSE F <br />PLUMBING CO MAIL AODRE55 <br />CITY 21P PNGNf <br />IICENMi F <br />CLASS OF W)q1( <br />❑NEW EIADOITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />WLUATKJN CF WORK <br />y <br />Install wood burning stove <br />I HEREBY I THAT I HAVE READAP- <br />LEGAL OESLRIPfIOrI OF PROPERJY ISIIOW BELOW <br />OR ATTACH TOUR COPIESI <br />PLICATION AND KNOW THE SAMFY <br />TO BE TRUE <br />LOT RLOLI._—OF <br />AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES <br />NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />JOO ADDRESS <br />2007 63rd Street <br />SIGNATURE OF DONTRACTOR OR AUTHORIZED AGENT DArf <br />X 12/6/62 <br />PLUMBING <br />MECHANICAL <br />N0. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT <br />WATER CLOSET DKETI <br />FEE <br />BATHTUB <br />AIR COND. UNITS — HP EA <br />LAVATORY ASH OAS[SHOWER <br />REFRIGERATION UNITS — H P EA <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA <br />FORCED AIR SYSTEMS — B.T.0 M EA. <br />WALL HEATERS — B.T U. M <br />UNIT I/EATERS — B7 U. M <br />EVAPORATIVE COOLERS <br />KITCHEN SINK 6 O1SP. <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />o nnn ...,.•.• <br />RANGE HOOD <br />CF <br />0' Hcc I SL I LIACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO <br />LOT AREA VACANT SITE <br />OYES LINO FEES VALUATION _ FEE <br />OCCUPANCY GROUP NO OF DWELLING UNITS <br />N0. OF STORIEb BUILUING y — <br />MAX. DOC. LOAD <br />PLUMBING <br />❑YES LINO .......-1 <br />17 50 <br />APPROVALS <br />BY DATE OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />2, BUILDING PLANS <br />PENALTY <br />U.BC <br />SEC. 303(A) <br />3. FIRE HYDRANT <br />TOTAL <br />17 50 <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />5 GRADING <br />- WHEN PROPERLY VALIDATED <br />- - <br />(IN THIS $�'A(;q TNIb I�•I/li PLq.I [ 0 <br />U / 0 V 11. 7 <br />8, DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />T'7 <br />8. HEALTH DISTRICT <br />' q�L*'g E C E I PT a <br />APPLICATION ACC. BY PLANS CI IECKED BY <br />APPR FOR ISSUANCE BY <br />r i H n N K YOU __q <br />ADDRESS FILE <br />11] <br />