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the EYergreen <br />IT) OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 <br />PONSTRUCTION <br />PERMIT <br />❑ COMBINATION L BUILDING IXXMECHANICAL <br />PERMIT NO. 11250 <br />L PLUMBING <br />UWNU' MAIL ADDRESS CITY ZR' '.HONE <br />James 0. Halvorson 1731 74th Street Everett_ _ 98203 353-4521_ <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE _. <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP P%InNE LICENSE I <br />MECHANICAL CONTRACTOR <br />Same <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE I <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSER <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR []DEMOLITION LJFLNCF. ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />E <br />DESCRIBE WORK <br />Install fireplace instert <br />PROPOSED USE OF BUILDIN3 <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 />CO TRUCTION OR THEPERFORMANCE OF CONSTRUCTION. <br />SI A RE OF CONT OR CjrAIjHOyED AGENT DATE <br />X 11/16/82 <br />LEGAL DESCRIPTION OF PROFERTY(SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT__BLOCK_DF <br />JOB PDDn[ES <br />1731 74th Street <br />PLUMBING <br />E ANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NTYPE <br />OF EQUIPMENT <br />FEE <br />WATER CL05L' ITOILET) <br />AIR COND UNITS — H P EA <br />BATHTIIB <br />REFRIGERATION UN :S — M.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H 1 EA. <br />_ <br />SHOWER <br />GAS FIRED AC UNITS —TONNAGE EA <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS — B T U M EA <br />DISHWASHER <br />WALL HEAT HAS — B T U. M <br />_ <br />LAUNDRY TRAY <br />UNIT HEATER', — B T U M <br />CLOTHES WASHER <br />I 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 — CT G <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK(SERVICE — BAR, ETC) <br />1 <br />_ <br />Fire lace Insert <br />SUB TOTAL <br />SUB TOTAL f <br />PERMIT 8 <br />PERMIT f <br />TOTAL FEE B <br />TOTAL <br />FEE t <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />EYES ENO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF SLOG. <br />NO. OF STORIES <br />MAX. DOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRED <br />❑YES ENO <br />MECHANICAL <br />17 <br />50 <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC 3031A) <br />2. BUILDING PLANS <br />TOTAL <br />17 <br />50 <br />3 FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT <br />O Q e <br />7 O �� —_ <br />54 <br />V C <br />.YO U,R R E4 y- c I PT a�-1 <br />;THANK YOU <br />8. DRAINAGE <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />�I <br />&►rY82 <br />ADDRESS FILE. <br />