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the Crrrerrrn S O N ST R U CT I O N <br /> everett PERMIT PERMIT NO. 10657 <br /> F Ulf) IIAII .",II11'V <br /> EVERETT.WA 48201 ❑ COMBINATION U BUILDING XX] MECHANICAL ❑ PLUMBING <br /> OWNER MAIL ADORL.','I CITY ZIP PHONE <br /> MR AND MRS ROBERT G. JOHNSON, JR 116 - 79th PL SE Everett WA 98203 355-1566 <br /> ARCHITECT OR DESIGNER MAIL ADDRE55 CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# <br /> Owner 1 <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# <br /> CLASS OF WORK <br /> UNEW ❑ADDITION ❑ALTERATION []REPAIR ❑DEMOLITION ❑FENCE ❑SIGN LIGARAGE <br /> VALUAIK)N OF WORK <br /> f <br /> DESCRIBE WORK <br /> Install wood stove <br /> PROPOSED USE OF BUILDING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGAL DESCRIPTION JFMTOPERTY(SHOW BELOW OR ATTACH FOUR COPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIUMS OF LAWS AND ORDINANCES GOVERNING THIS <br /> L07 BLOCK—Of 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 /> JOB AOJ E S SIGNATURE OF WNTRACTOR OR AUTHORIZED AGENT DATE <br /> ��6 - 79th P1 SE X 6/10/82 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND UNITS—H P EA <br /> _ BATHTUB REFRIGERATION UNITS— H P LA <br /> LAVATORY(WASH BASIN) BOILERS—H EA _ <br /> SHOWER GAS FIRED AC UNITS—TONNAGE EA _ <br /> _ KITCHEN SINK&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 I EVAPORATIVE COOLERS <br /> WATER HEATER ICLOTHES DRYERS _ <br /> URINAL I VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C'M <br /> VACUUM BREAKERS JSTOVL <br /> E4OOF DRAINS—RAINLEADERS I METAL FIREPLACE E CHIMNEY <br /> SINK(SERVICE—BAR,ETC —Woodd-stove 7 <br /> SUBTOTAL SUBTOTAL 7 50 <br /> PERMIT f PERMIT $1 10 00 <br /> TOTAL FEE f TOTAL FEE $1 17 <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHEC\NUMOLR PLAN CHECK Fti, <br /> FEE RECEIPT 140 <br /> USE ZONE LOT AREA VACANT SITE <br /> IYES ONO FEES VALUATION FEE <br /> TYPE 0'CONST. OCCUPANCY GROUP NO OT DWELLING UNITS <br /> BUILDING If <br /> 517E OF BLDG NO OF STORIES MAI; OCC.LOAD <br /> PLUMBING <br /> �. FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REQUIRED MECHANICAL 17 50 <br /> IYES LINO <br /> APPROVALS BY DATE OTHER <br /> I ENVIRONMENTAL CHECK LIST PENALTY U SEB <br /> G <br /> SEC.3031#1 <br /> 2 BUILDING PLANS - <br /> 3. FINE HYDRANT TOTAL 1 7 5O I <br /> -' 4. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED VN THIS SPACE)THIS 15 YOUR PERMIT <br /> 5 GRADING <br /> r- <br /> 6. DRAINAGE <br /> 7. ENVIRONMENTAL 1MPA^T STATEMENT } 6 6 6 S 017.5 0 b4 <br /> B, HEALTH DISTRICT <br /> c—� <br /> APPLICATION ACC.BY PUNS CHECKED BY #FPR FOR ISSUANCE BY <br /> YOUR RECEIPT <br /> THANK YOU <br />