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Me Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 <br />';ONSTRUCTION <br />PERMIT <br />❑ COMBINATION ❑ BUILDING �_* MECHANICAL <br />PERMIT NO. 10726 <br />LJ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Richard A. Hardon 1916 73rd Street Everett 98203 353-2266 _ <br />ARJHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />"9 UMBINO CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />L^. V ^ 1 ❑NEW ❑ADDITION ❑ALTERATION OREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />s <br />install chimnev and wood stove <br />PROPOSED USE OF BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE 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 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 />SIGNATURE f TRACTOR OR AUTH IZED A NT DATE <br />X� 6/29/82 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />IGT OLOCK_OF <br />JOB A DRESS <br />�916 73rd Street <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />I TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />I AIR COND UNITS — H.P. EA <br />_ <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H P. EA. <br />SHOWER. <br />GAS FIRED AC. UNI75 —TONNAGE EA <br />_ <br />KITCHEN SINK b DISP. <br />FORCED AIR SYSTEMS — B.T.U. AI EA. <br />DISHWASHER <br />WALL HEATERS — B T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B T.U. M <br />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />_ <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />1 <br />AIR HANDLING UNIT — C F M <br />STOVE Wood <br />7 <br />50 <br />_ <br />gOOF DRAINS — RAINLEADERS <br />METAL FIREPLACE b CHIMNEY <br />SINK (SERVICE — BAR. ETC.I <br />BUS TOTAL <br />SUBTOTAL f <br />PERMIT <br />f <br />PERMIT E <br />OL <br />TOTAL FEE <br />f <br />TOTAL <br />FEE f17 <br />SIUL YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />LIYES IINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG <br />FIRE ZONE <br />N0. OF STORIES <br />BABEMENT <br />MA% DOC LOAD <br />gEOUIIRE RED KLERS <br />REOUI I)YES t )NO <br />PLUMBING <br />MECHANICAL <br />17 <br />SO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />I ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC 303(a) <br />2 BUILDING PLANS <br />TOTAL <br />17 <br />50 <br />3 FIRE HYDRANT <br />n FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACE)THISIS YOUR PERMIT (c�� <br />4 M S S 17. 5 0 "^• c(7 <br />LV <br />~ <br />YOUR RECEIPT,-i <br />lf H AN K Y61) <br />5, GRADING <br />G DRAINAGE <br />7 ENVIRONMENTAL IMPACT ITA7EMENT <br />B HEALTH DISTRICT <br />APPLICATION AGO. BY <br />PLANS CHECKED BY <br />APPn. FOR ISSUANCE DV <br />If <br />29A82 <br />ADDRESS FII.E <br />