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L <br />IN, !- r(•rcn•rN <br />� <br />everett ON ST R U CTI O �' <br />PERMIT <br />CITY HALL 259-8715 <br />PERMIT NO. 12772 <br />EVERETT, WA 98201 <br />El COM31NATION LJ BUILDING <br />XX MECHANICAL <br />PLUMBING <br />OWNS] <br />MAIL ADDRESS <br />Clir <br />PHOE <br />Allen F. 3XA*XXFM <br />2517 Blot Place S.E. <br />Everett <br />98203 355- 918 <br />ARCHITECT OR DESIUNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />GENERAL CONTAACCR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />Same <br />PLUMBING CCNTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />❑ NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN 0 WOOD STOVEIFIREPLACE INSERT <br />f <br />DESCRIBE WORK <br />Install wood 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 />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 EGULATING CONSTRUCTION OR THE <br />PERF N F CONSTRUCTION. <br />610N ORE O R TOR OR AUTHORIZED ALERT DATE <br />X ° 12/2/83 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />49T YE BLOCK —OF Valley View All <br />_ <br />JOB ADDRESS <br />2517 81st Place S.E. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE O E IPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR CONED. — .. EA. <br />BATHTUB <br />REFRIGERATION UNITS — HP EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />OAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK B DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHESWASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <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 />I <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE B CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />BUD TOTAL $1 <br />1 <br />SUB TOTAL 1 <br />7 <br />50 <br />PERMIT 1 I <br />I <br />I PERMIT <br />TOTAL FEE 11 <br />1 <br />TOTAL FEE 1 <br />S1DE YARD SETBACK <br />STREET SE78ACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PUN <br />FEE <br />CHECK FEE <br />RECEIPT N0. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />AYES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />1 <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />17 <br />50 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B C. <br />SEC, 303181 <br />2 TUILUING PLANS <br />TOTAL <br />17 <br />50 <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THI� BP�LCEI THISBSIYOUB P5F jT1 _ f� <br />J[ L ,1 U I/ l U <br />q _ l V <br />I r� ' ` y C r �' FIT1, Y <br />.I If. 1C.'U <br />S. DRAINAGE <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHE2KED BY <br />APPR. FOR ISSUANCE BY <br />- 2 iiC 81 <br />ADDRESS FILE <br />