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the Evergreen <br /> C O N ST R U CT I O I` <br /> CITYY O OF F <br /> everett PERMIT PERMIT NO. 06952 <br /> CITY HALL 259.8745 <br /> EVERETT,WA 98201 ❑ COMBINATION ki BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAIL ADDRESS CITY ZIP PI4ONL <br /> Steven G. Brown 2501 Euclid 98203 355-6387 <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br /> Same <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP FHCNE LICENSE <br /> CLASS OF WORK ' <br /> ❑NEW ❑ADDITION M ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE [I SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> $ 2,000.00 ` <br /> DESCRIBE WORK <br /> Convert single family residence to Duplex <br /> PROPOSED USE OF BUILDING t <br /> Duplex I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> LOT 23 BLOCK 12 OF Pinehur_st Div. A 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 ADDRESS SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> 2501 Euclid X r . 11/15/79 <br /> i ` <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 REi RIGERATION UNITS—H.P.EA <br /> LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED A C UNITS—TONNAGE EA <br /> KITCHEN SINK 8 DISP. _ I ORCED AIR SYSTEMS—B T U M EA <br /> DISHWASHETi I WALL HEATERS—B.T.0 ht <br /> LAUNDRY TRAY UNIT HEATERS—B.T.0 M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKIIJG FOUNTAIN RANGE ROOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C F.M <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE—BAR,ETC) <br /> SUB TOTAL SUB TOTAL $ <br /> PERMIT SI PERMIT S <br /> TOTAL FEE $ TOTAL FEE S <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 <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS ` <br /> BUILDING S 00 00 I <br /> SIZE OF BLDG. NO OF STORIES MAX.OCC.LOAD <br /> PLUMBING �J <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REQUIRED MECHANICAL <br /> f1YES (]NO <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST <br /> PENALTY U B C. <br /> Z. BUILDING PLANS SEC.303(a) <br /> k 3. FIRE HYDRANT tr TOTAL 00 00 I` <br /> 4. FIRE PROTECTION SYSilM PERMIT VALIDATION <br /> .5. GRADING <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> �{ <br /> s oRAI E►. Environmental ENEXI$SK Checklist not CV-" - required. Bob Lnadles 11/15/79 L0 <br /> Awn7. ENVIR>M5&AL IMP STATEMENT Single Family residence existing and only C7) <br /> CD <br /> ! 8. HEAL -DID ICT sheetrocking needed for conversion to a <br /> A_PPUPAVION i0t.BY LANS CHECKED BY APPR.FOR ISSUANCE BY Duplex. CD <br /> n Fee MMXXMKKSX collected on Permit #6926. <br /> m 11/9/79 <br /> I <br /> ADDRESS FILE <br />