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FT <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 <br />CONSTRUCTION' <br />PERMIT <br />J I COMBINATION ❑ BUILDING Ll MECHANICAL <br />PERMIT NO. 10680 <br />❑ PLUMBING <br />OWNER <br />BILL STILLWELL <br />MAIL ADDRESS <br />7806 BEVERLY BLVD <br />EVERETT�3' <br />355-5052 PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />BLAKELY CAMP HOMES <br />GENERAL CONTRACTOR <br />BLAKELY CAMP HOMES <br />MAIL ADDRESS <br />PO BOX 3035 EVERETT <br />CITY <br />BLAKELH2O2 <br />ZIP PHONE LICENSE <br />PC <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE) <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑NEW MADDITION ❑ALTERATION ❑PEPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALE ATily QppDY{{(O060 <br />DESCR1OEFIWFIR7Qi en. ft. <br />PROPO$�Q�^Y�ERTING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL D(ESSCCRIIPTIOON�VOFFttPM RTY(SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 5 I,LGOK.LGF Ram Park <br />TYPE OF WORK. WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TOVIOLAT ORCANCEL THE PRO- <br />VISI S 0 ANY OTHER STATE OR L LAW REGULATING <br />CO T U TION OR THE37FM E OF CONSTRUCTION. <br />SIO AT EORACTOR OR T DATE <br />6/21 /82 <br />JOR ADDRESS <br />TAnF a <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS— H.P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA, <br />SHOWER <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TPAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />_ <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT— C.F.M. <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK SERVICE — BAR. ETC.) <br />SUBTOTAL <br />00 <br />$TOTAL f <br />UB <br />310 <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />TOTAL <br />FEE <br />f <br />SIDE YARD SETBACK STREET SETBACK <br />REAR YARD BE *BACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />6 ft 20 ft <br />20 ft <br />82/10680 <br />FEE <br />48.43 <br />RECEIPT NO <br />58205 <br />USE ZONE <br />LOT AREA <br />VACANT <br />A SNTLSITE 0 <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />7.AA <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />517,000, <br />122 <br />50 <br />V-N <br />R-3 Addn <br />1 <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX. OCC. LOAD <br />792 s . ft. <br />2 <br />PLUMBING <br />6 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE REOUISPRINKLERS <br />MECHANICAL <br />3 <br />00 <br />OYES NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PUNS ..,, <br />TOTAL <br />131 <br />6 <br />.,3. FIRE HYDRANT <br />4. FIRE ION M SYSTE <br />PAQ <br />PERMIT VALIDATION <br />y� Fqt�.�: F0(gERI Y VA1_TED (IN THIS SPACE) THIS IS YOUR PERMIT <br />s:diu0 C_ <br />D UV <br />U$31.20 due on Plan Check Fee, qq o <br />4 I S i $.' L 1. t J ,O <br />RECEIPT .. <br />�--1 <br />N K YOU <br />' 8. DRAII EA Q! <br />7. ENVIFVMNWAL IMP9 STATEMENT <br />B. HEAL DI ICT <br />APPLIC NPLQC. BY (PLANS CHECKED BY <br />APPR. FOR ISSUAN �- <br />YO U.R R E1C*IP? <br />EB C .D HWM <br />LC <br />HANK 'YOU <br />.. O 9 <br />ADDRESS FILE <br />