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. _ , <br />� � <br /> . - - - <br />� the Grergrren <br /> everett r �ONSTRUCTIO�� • <br />� � qTVNALL259�8745 PERMIT PERMIT NO. 1Z114 <br /> EVERE7T,WA 98201 � COMBINATION X� BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNEfi CORNELIA PETERS MAILApDRE55 arr ziv PHONE <br /> 1309 BROADWAY 'cVERETT WA 98?..11 7.52-0118 <br /> � ARCNITECT OR OESIGNEN MAIL AO�FESS LITY 21P PHONE <br /> IGENERAL CANTPALTOR MAIL RODRESS CITY ZIP PNONE LIGENSE Y <br /> I� EVERETT BLDRS 5606 Evergreen Way Everett WA 98203 353-7161 <br /> MECMANILAL LONTRACTOR MRIL RDDFE55 CITY ZIP PMONE LICENSE� <br /> PWMBING CONTRRCTOR MAIL ADDPE55 CITY ZIP PHONE LICENSE� <br /> � <br /> � C1A55 OF WORK <br /> O NEW ❑ ADDITION X� ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VRLUATION O'WORK <br /> s 3275.00 <br /> DESCRIBE WOFK <br /> Reroof - composition <br /> PROPOSED USE UF BUIL�ING <br /> Single family re5idence IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHIS <br /> APPLICATION AND KNOVJ THE SAME TO BE TRUE AND <br /> LEGALDESGflIPiIONOFPPOPERTY�SH0INBELO\YORATTACNFOUPGOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �oT 566 BLOCK25� oF Powers 2nd Add GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLL.TE <br /> — OR CANCEL THE PROVIS�ONS OF ANY OTHER STPTE OR <br /> LOCAL� LAW, GULATING CONSTRUCTION OR THE <br /> PEAFO MANC F CONSTR CTION. <br /> JOB AOORE55 SIGN TU OF CONT TOR OR AUTM IZE AGENT DRTE <br /> 1309 Broadway X <br /> PLUMBING MECHANICAL � <br /> MU. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATEACLOSET�TOILEn AIR COND. UNITS— H.P. EA. <br /> BATNTUB REFRIGERATION UNITS — H.P.EA. <br /> LdVA70RY�WASH BASINI BOILERS— H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS— TONNAGE EA. <br /> KITCHEN S�NK 8 DISP. FOflCED AIR SVSTEMS— B.T.U. M EA. <br /> DISMWASMER WALL NEATEFS— B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER MEATER CLOTHES DRYERS <br /> URINAL �ENTILATION FPN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DHAIN A�R HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WO00 <br /> ROOF DHAINS— RAINLEA�ERS METAL FIREPLACE&CMIMNEY <br /> SINK(SERVICE— UAfl,ETC.� FIREPLACE INSEflT <br /> HEAT PUMP <br /> SUB TOTAL 5 SUB TOTAL f i <br /> PEPMIT S PERMIT f ' <br /> TOTAL FEE f TOTAL FEE S <br /> SIDE YAR�SETBACK STREET SETBACK tiEAR VARD SETBACK PLAN CHECK NUMBEfl PLAN CMECK FEE � <br /> FEE RFCEIPT N0. <br /> 115E ZONE LOT AREA VACANT SITE i <br /> I::YES I�NO FEES VAWATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF OWELLING 11N1T5 <br /> BUILDING sp375.00 38 50 � <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MF.CHANIGAL <br /> REOUIRED � <br /> ' . YES i-.NO � <br /> APPROVALS BY OATE OTHER <br /> 1.ENVIRONMENTAL CHECK U5T PENALTY U.B.C. I <br /> SEQ JD3�a� <br /> 2.BUIIDING PLAIJS <br /> 3.FIREHYDRANT TOTAL 38 5O <br /> 4.F;RE PRO?ECTION SVSTEM PEflMIT VRLIDATION <br /> 5.GRADING WHEN PROPERLY VALIDA7E��IN THI 8 3�O THIS�x�fhPF�7�1T—�� I <br /> 6.DRAINAGE u �` 7 <br /> 7.EN VIRO',MENTAL I MPACT STATEMEN7 � <br /> N <br /> B.HEALTH DISTRICi <br /> APPLIGATION ACC.BY PLANS CHECKED BY APPH.FOR ISSUANCE eY `�O U R REC E I PT� <br /> Tl-lANK YOU <br /> I <br /> 2 I WI1 0.1 <br /> ADDRESS FILE <br /> _ � <br />