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The Evergreen <br />CITY OF <br />everett <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 <br />�. CC1STRUCTION <br />PERMIT <br />❑ COMBINATION ❑ BUILDING L MECHANICAL <br />PERMIT NO. 07751 <br />L PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />George H. Magrudee 6321 Beverly Alvd. F.veratt QR7n7 '15q-SS17 <br />ARCHITECT ON DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE # <br />Same BIB above <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CUSS OF WORK <br />❑NEW ❑ADDITION E36LTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />f 4000,00 <br />DESCRIBE WORK <br />Rnnlnaa I.ArMr}. ir,H ll 14_h1 .� -1.... 4__ <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AR, <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 -18-80 <br />LEOALDESCIIPTIONOFPROPERTY ISHOWBELOW ORATTACH FOUR COMES) <br />LOT RLOCK — <br />Tract 1. North Beverly Park Vnl. 10 of Plat <br />Page 26 <br />JOB ADDRESS <br />6321 Beverly Blvd. <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(TOILET) <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 />2 <br />00 <br />GAS FIRED A.C. UNITS —TONNAGE EA <br />1 <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 />EVAPORATIVE COOLERS <br />WATER HEATER <br />2 <br />00 <br />CLOTHES DRYERS <br />URINAL <br />VF"TILATION 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 — RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE — BAR ETC. <br />SUBTOTAL <br />oo <br />SUBTOTAL f <br />PERMIT i <br />3 <br />00 <br />PERMIT f <br />_ <br />TOTAL FEE i <br />TOTAL <br />FEE i <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />7751 <br />PLAN CHECK <br />FEE <br />14.00 <br />FEE <br />RECEIPT NO. <br />49084 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCC FANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />44000.00 <br />28 <br />00 <br />SIZE OF BLDG. <br />16X19 <br />NO, OF 6TORIES <br />1 <br />MAX. OCC. LOAD <br />PLUMBING <br />11 <br />00 <br />FIRE ZONE <br />2 <br />BASEMENT <br />FIRE <br />❑ REOUIRED <br />SPRINKLERS <br />D <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />39 <br />00 <br />3. FIRE HYDRANT w <br />4. FIRE PROTECTION SYsrw <br />5. GRADING ..< r <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3627 5029.00 -- to <br />f� <br />YOUR RECEIPT O <br />THANK YOU <br />S.OPAI E 0 <br />:,e. ENVIR I M AL IMPAtftATEMENT <br />HEALTHDISTRICT <br />OG 'APPLICATION fri. BY . �PLANSVHE`CKEO BY <br />c Fr <br />APPR. FOR ISSUANCE BY <br />_ -4 <br />W ADDRESS FILE I R Al 80 <br />