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the Evergreen <br />^ O IN ST R <br />U CT I O N <br />an of <br />� <br />evereff <br />PERMIT PERMIT NO.09195 <br />CITY HALL 259-8745 <br />❑ COMBINATION <br />❑ BUILDING )N MECHANICAL CS PLUMBING <br />EVERETT, WA 98201 <br />OWNER <br />John Bitto 9302 44th <br />MAIL ADDRESS <br />Place S.E. <br />GlY ZIP PHONE <br />Snohomish 98290 334-8659 <br />ARCHITECT OR DESIGNER <br />MAILADDRESS <br />CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE LICENSE I <br />John Bitto <br />MECHANICAL CONTRACTOR <br />li <br />MAIL ADDRESS <br />CITY ZIP PHONE LICENSE# <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE LICENSEP <br />. <br />CLASS OF WCRK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />f <br />DESCRIBE WORK <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />LEGAL DESCRIPTION OFPROPERTYISHOWBELOWORATTACH FOUR COPIES) <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT LOCKOF <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 />SIGNATU OFCONTRACTOR UTH EDA N DATE <br />JOB ADDRESS <br />�j► !" 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 MASH BASIN <br />BOILERS - H.P. EA <br />SHOWER <br />GAS FIRED AC. UNITS - TONNAGE EA. <br />KITCHEN SINK S DISP. <br />FOPCED 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 />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 - RAINLEADERB <br />METAL FIREPLACE & CHIMNEY <br />SINK(SERVICE -BAR, ETC. <br />SUB TOTAL <br />8.00 <br />SUB TOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />11 <br />100 <br />TOTAL FEE f <br />SIDE YARD SETBACK STREET SETBACK <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />BEAR YARD SETBACK <br />FEE RECEIPT NO. <br />USE ZONE LOT AREA <br />FEES VALUATION FEE <br />VACANT SITE <br />DYES ONO <br />TYPE OF CONST. OCCUPANCY GROUP <br />. <br />NO.OF DWELLING UNITS <br />BUILDING f <br />' <br />SIZE OF BLDG. NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING 11 go <br />FIRE ZONE BASEMENT <br />MECHANICAL <br />FIRE SPRINKLERS <br />RLOUIRED <br />IYES ❑NO <br />APPROVALS <br />OTHER <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY U.B.C. <br />SEC. 303 IQ <br />2. BUILDING PLANS <br />11 00 <br />TOTAL <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />PERMWHEN IPROPERLYI VALIDATED (IN THIS SPAff1 THE IS YOQF�'+gITO <br />�P <br />5. GRADING <br />11 1 <br />I� <br />B. DRAINAGE <br />1 I� <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />�I j C:) <br />APPR. FOR ISSUANCE BY <br />APPLICATION ACC. BY PLANS CHECKED BY <br />'1 y <br />