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Ihr lCrercreen <br />everett <br />Cl' V HALL 259 8745 <br />E'. ERETT, WA 98201 <br />CONSTRUCTI%N <br />PERMIT <br />❑ COMBINATION ❑ BUILDING t—X MECHANICAL <br />PERMIT NO. 15470 <br />❑ PLUMBING <br />OWNLR MAIL ADDRESS CITY ZIP PHONE <br />Jeffrey T. Tri 2206 74th Street Everett 98204 355-5627 <br />ARC$P (ECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 4 <br />Everett Fireplace Shop 7017 Evergreen Way Everett 98203 353-3722 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 0 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />CLASS OF WORK <br />❑ NEW 11 ADDITION ❑ ALTERATION ❑ ACPAIR ❑ DEMOLITION O FENCE ❑ SIGN Ak WOOD STOVEIFIREPLACE INSERT <br />PRUPOSED USE OF BUILDING <br />I HEREBY CERTIFY 1 HAT 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 OF CONTRACTOR OR AUTHORIZER AGENT DATE <br />X 9/24/85 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT --BLOCK-OF <br />JOB ADDRESS <br />2206 74th Street <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 — M.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — M.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — N.P. CA. <br />_ <br />SHOWER <br />OAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />_ <br />LAUNDRYTRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />_ <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 — P' INLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />1 <br />FIREPLACE INSERT <br />7 <br />50 <br />HEAT PUMP <br />SUB TOTAL 11 <br />SUB TOTAL f <br />7 <br />50 <br />PERMIT S <br />PERMIT 3 <br />10 <br />00 <br />TOTAL FEE $1 <br />TOTAL FEE 111 <br />17 <br />50 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />C;YES !:NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />— <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />IRED <br />YES NO <br />MECHANICAL <br />17 <br />50 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL HECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (B) <br />2. BUILDING PLANS <br />TOTAL <br />17 <br />$O <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />&GRADING <br />PERMIT VALIDATION ,�` <br />WHEN PROPERLY VALIDATED (IN TH� OW THI4tjUj Prj FIT <br />J7 <br />7. <br />Y'U R R f C G I PT .�-� <br />rt-IAraK You <br />S. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />BHEALTH DISTRICT <br />APPLICATION ACC. BY <br />I PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />1hSO85 <br />ADDRESS FILE <br />