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r ONSTRUCTION <br /> everett PERMIT PERMIT N0. .4292 <br /> CITY HALL 2598745 <br /> EVERETT.WA 98201 L COMBINATION BUILDING FU MECHANICAL PLUMBING <br /> OWNER MAIL ADDR EBB CITY PHONE <br /> Reuben E. Lobb 209 7C Ch Place S.W. Everett 98203 353-8208 <br /> ARCHITECT OR DESIGNER Mi IL ADDRESS CITY SIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY IIP PHONE LICENSE a <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br /> Same <br /> PLUMBING WNTRACTOR MAIL ADDRESS CITY IIP PHONE LICENSE 4 <br /> CLASS OF WORK <br /> ❑NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR 11 DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> f <br /> DESCRIBE WORK <br /> Install woodburninq stove <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIES( CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT_BLOCK-OF 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 CONSTRUCT;ON. <br /> JOB ADDRESS SIONATU F CONTRACT^R RUTH 12E0 AGENT DQE <br /> 209 76th Place S.W. j( 12/24/84 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR GOND.UNITS— H.P.EA. <br /> BATHTUB REFRIGERATION UNITS— M.P. EA. <br /> LAVATORY(WASH BASIN) BOILERS— M.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 6 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS — B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS — B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD — <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. z <br /> VACUUM BREAKERS STOVE —WOOD _ Q <br /> ROOF DRAINS— RAMLEADERS METAL FIREPLACE A CHIMNEY F- <br /> SINK(SERVICE — BAR,ETC.) FIREPLACE INSERT •� <br /> HEAT PUMP <br /> SUB TOTAL f BUB TOTAL A 7 50 H <br /> PERMIT S PERMIT $ 10 DO <br /> TOTAL FEE S TOTAL FEE S 17 50 <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE -- — E <br /> _FEES VALUATION FEE <br /> . YES NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING _ !. <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL 17 $0 <br /> REQUIRED po <br /> YES NO <br /> APPROVALS BY DATE OTHER F1 <br /> 1, ENVIRONMENTAL CHECKLIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLANS 17 50 p <br /> 3.FIRE HYDRANT TOTAL <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> _. <br /> B.DRAINAGE <br /> — N <br /> 7.ENVIRONMENTAL IMPACT STATEMENT <br /> 8.HEALTH DISTRICT . TA <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR. FOR ISSUANCE BY 1 <br /> I <br /> r <br /> ADDRESS FILE <br />