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r TP0i CONSTRUCTION <br />ever tt PERMIT PERMIT NO.07750 <br />CITY HALL2 -8745 <br />EVERETT, WA 201 ❑ COMBINATION ❑ BUILDING Ll MECHANICAL El PLUMBING <br />ARCHITECT CTI <br />DESIGNER <br />MA <br />ADDRESS <br />CITY <br />ZIP <br />PHONE <br />.I .L I IJIJ L. <br />CLASS OF WORK <br />❑NEW ❑AODITI N Q�LTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />.UATION OF WORK <br />f C.nn nn <br />PROPOSED USE OF BUILDING <br />offirn <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X 6-18-80 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW ORATT HFOURCOPIES) <br />LOr BLGCK_.—OF \ <br />\\ " <br />JOB ADDRESS \ <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE _ <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET OIL <br />\ <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H.P. EA. <br />1 <br />SHOWER <br />00 <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />KITCHEN SINK 6 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 />CLOTHES WASHER <br />I EVAPORATIVE COOLERS <br />WATER HEATER <br />2 <br />O <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 />STOVE <br />ROOF DRAINS — RAINLEAOERS <br />METAL FIREPLACE f CHIMNEY <br />SINK SERVICE — BAR. ETC.) <br />SUBTOTAL <br />u <br />UU <br />SUBTOTAL f <br />PERMIT <br />f <br />3 <br />100 <br />PERMIT f <br />TOTAL FEE <br />$1 <br />11100 <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO <br />— <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />4 6000.00 <br />36 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX DOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />REOUIRED <br />OYES <br />SPRINKLERS <br />ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC <br />SEC -303ILA) <br />2. BUILDING PLANS <br />TOTAL <br />47 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VAI.IDATION <br />WHEN PP.,PERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />O <br />r <br />— <br />5. GRADING <br />S. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR FOR ISSIjANCE BY <br />ADDRESS FILE <br />