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the Ev <br /> C17YOF F.- "ONOSTRUCTION <br /> GlY OF <br /> everett PERMIT PERMIT N0. 13930 <br /> CITY HALL 2598745 <br /> EVERETT,WA 98201 COMBINATION LJ BUILDING xX MECHANICAL U PLUMBING <br /> UVJH R MAIL ADDRESS CITY ZIP PHONE <br /> Rod B. Foist 302 76th Place S.W. Everett 98203 347-3945 <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> 21P "ONE LICENSE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> Same <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br /> CLAS80F WORK <br /> ❑NEW O ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION C] FENCE C3 SIGN 7(a WOOD STOVEIFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S <br /> DESCRIBE WORK <br /> Install wood stove <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL GESCP,HTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT._BLGCK_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 08 <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRESS SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> 302 76th Place S.W. X 9/17/84 <br /> PLUMBING MECHANI AL <br /> N0. TYPE uF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNITS—M.P.EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS— H.P.EA. <br /> SHOWER OAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK S DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRYTRAY UNIT HEATERS—B.T.U. M <br /> CLOTHESWASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN .9ANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS S1 OVE —WOOD 7 Rn <br /> ROOF DNAINS— RAINLEAOERS METAL FIREPLACL d CHIMNEY <br /> SINK I 'VICE— BAR,ETC.) FIREPLACE INSERT <br /> HEAT PUMP y :- <br /> H C- <br /> Npg f <br /> BUB TOTAL i SUB TOTAL f 7 50 TTJ l <br /> PERMIT S PERMIT f 10 00 'a- <br /> TOTAL FEE f TOTAL FEE t 17 150 <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. 1 <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> YES NO ; <br /> TYPE OF CONST. OCCUPANCY GROUP NO, OF DWELLING UNITS <br /> BUILDING f O <br /> SIZE OF BLDG. NO.OF STORIES MAX OCC. LOAD Y' <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL 17 50 N <br /> REQUIRED <br /> YES NO <br /> APPROVALS BY DATE OTHER <br /> U.B C. <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY <br /> SEC.70710 <br /> 2.BUILDING PLANS TOTAL 17 50 <br /> 7.FIRE HYDRANT <br /> 1.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> S.GRADING WHEN PROPERLY VALIDATED TIN TH�S!SrA?E)THIB IB Ypl]R TIT <br /> S.DRAINAGE { Il I/ 7 J 7T <br /> CF) <br /> 7.ENVIRONMENTAL IMPACT STATEMENT r m <br /> B.HEALTH DISTRICT •` �' I FT T-4 <br /> APPLICATION ACC.BY PLANE CHECKED BY APPR.FOR ISSUANCE By 11 <br /> 1 u tuJ G 4 <br />