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;ONSTRUCTIOPF <br />everett <br />PERMIT PERMIT NO. 15894 <br />CITY HALL 259 H745 <br />11 <br />EVERETT, WA 98201 F-1 COMBINATION <br />LI BUILDING F] x MECHANICAL PLUMBING <br />OWNER MAIL AODR69 Lily III, PrIpNF <br />Raymond White 804 91St Place <br />S.E. Everett 98204 355-0157 <br />ARCHITECT UR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />CLASS OF WORK <br />❑ NEW ❑ADDITION O ALTERATION O REPAIR ❑DEMOLITION ❑FENCE ❑SIGN Kii WOOD STOV:JFIREPLACE INSERT <br />Y .LUATION OF WORK <br />DESCRIBE WORK <br />Install wood stove <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />z <br />O <br />� <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />IEGALOESCRIPTION OF PROFERTYISHOW BELOW OR ATTACH FOUR COMES) <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />m <br />GOV-IANING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT -BLOCK --OF _ —_ <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />— <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />_H <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />1Am <br />PERFO N6' F CONSTRUCTION. <br />c <br />JOB ADDRESS <br />51GNAT 0' CONTRAC R OR AUTHOR ED AGENT DATE <br />1/6/06 <br />o <br />cz <br />804 91st Place S.E. <br />X �[. �;�� <br />-m4 <br />CD A, <br />PLUMBING <br />MECIIANI AL <br />~ <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />m <br />WATER CLOSET (TOIL" <br />AIR COND, UNITS - H.P. EA <br />_ <br />C <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />D -H <br />LAVATORY(WASH BASIN) <br />BOILERS — H.P. EA. <br />N <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />-< T <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA, <br />O <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />F0 <br />LAUNDRY TRAY <br />U <br />UNIT HEATERS — B.T.. M <br />:C <br />m� <br />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />L <br />WATER HEATER <br />CLOTHES DRYERS <br />m <br />URINAL <br />VENTILATION FAN <br />N <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />— <br />.� Frl <br />VACUUM BREAKERS <br />_ <br />STOVE —WOOD <br />7 <br />S <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE B CHIMNEY <br />SINK (SERVICE — BAR, ETC) <br />FIREPLACE INSERT <br />S' <br />> <br />HEAT PUMP <br />z <br />S <br />Ln <br />SUB TOTAL <br />i <br />SUB TOTAL f <br />7 <br />50_ <br />PERIAIT f <br />PERMIT <br />TOTAL FEE <br />f <br />TOTAL <br />FEE f 17 , 50 <br />Fri <br />SIDE YARD SETBACK <br />PLAN CHECK FEE <br />STREE' SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />FEE RECEIPT NO <br />USE ZONE <br />VALUATION FEE <br />LOT A ER <br />VACANT SITE <br />FEES <br />YfS NO <br />TYPE OF CONST. <br />GJUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIIE OF BLDO. <br />NJ. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE BASEMENT <br />RIRE KIERS <br />MECHANICAL <br />17 <br />SO <br />EQUIRED <br />YES NO <br />— <br />APPROVALS <br />OTHER <br />BY <br />DATE <br />U.S.C. <br />SEC. 303 (a) <br />1. ENVIRONMENTAL CHECK LIST <br />_ <br />PENALTY <br />17 <br />2, BUILDING PLANS <br />50 <br />TOTAL <br />9 FIRE HYDRANT <br />A. FIRE PROTECTION'SYSTEM <br />B.ORADINO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED UN THISSPACE)GSPACCE) THIS IS�YQUji. O PERMIT <br />75 UU S II II 55 <br />6. DRAINAGE <br />DO <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />_ u') <br />P. HEALTH DISTRICT <br />f` �\ L, l� F I PT f"'+ <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />-6im8G <br />ADDRESS FILE <br />.. I <br />