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' rhr£rerQreen " C O N ST R U CT I 0 P'� - <br />� arar �- <br /> e`�erett PERMIT PERMIT NO. �-24� 5 <br />� CITV HALL 25@�B7t5 <br /> ' E'✓ERETT,WA96::J7 ❑ COMBINATION I�xBUILDING ❑ MECHANICAL ❑ PLUMBING <br /> - GTY ZiP PMONE <br /> OWNLa MAIL AODRESS 98201 252-3661 <br />� Everett <br /> Oiiver Williams 1915 Broadway Z,P pHONE <br /> ARCMITECT OR DESIGNER <br /> MAIL RODRESS GTV <br /> I GENERlL CONTRAGTOR NAiL AODFE55 <br /> - QTY 2IP PMCNE ULENSE� <br />, � L nnwood 98026 771-2494 <br /> I & R Cons:ruct3on 19725 Highwa 99 �TY Z,P P„oNE uGENSEM <br /> MEGNANIGAL CAMtA�GTOfl MAIL ADDRE55 Ig�pry.72L6 <br /> PLUMOING CONTRAGTOR MRIL ADORE65 <br /> GITY ZIP PNONE LICENSE M <br />�' CUS&OF WORR <br /> ❑ryEW ❑ ADDITION �ALTERATION ❑REPAIR ❑ DEMOLITION O FENCE ❑ SIGN O WOOD STOVE/FIREPLACE INSERT <br /> i� VAWIQION OF WOFK <br /> I s 19,000. <br />` DESCHIBE WORK <br /> Addition to existing structure <br /> PROPOSEO USE OF BUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> gingle Family Residence qppLiCATION AND KNOW THE SAME TO BE TRUE AND <br /> IEGALOESGPIPT10NOFPNOPEHiY�SHOWBELOWORRRACMFOURCAPIES) �;ORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 8 384 Everett GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �or_e�ocK_oF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. oaTE <br /> SIGNATUR F GONTRAGTOR OP AUiHORIZE�AGENT , <br /> JOB ADDRE55 X � �, i �{ �,i <br /> 1915 Broadway <br /> MECNANICAL <br /> PLUMBING FEE <br /> FEE NO. TYPE OF EOUIPMENT <br /> N0. TYPE OF FIXTURE OR ITEM p�q COND.UNITS— H.P.EA. <br /> 1 WATERCLOSET(TOILET) 2 00 <br /> ], BATHIUB 2 OO REFRIGERATION UNITS— M.P.EF. <br /> ], LAVATORY(WASHBASIN) <br /> 2 00 BOILERS— H.P.EA. <br /> GAS FIRED A.C. UNITS —TONNAGE EA. <br /> £HOWER <br /> ]. KITGHEN SINK fl DISP. Z OO FORCED AIR SYSTEMS— B.T.U. M EA. <br /> WALL MEATE(iS— B.T.U. M <br /> DiSMWASHER <br /> _ UNIT HEATERS— B.T.U. M <br /> LFUNDRYTRAY <br /> 1 CLOTHES WASHER 2 00 EVAPORATIVE COOLERS <br /> 1 WIITER HEATER Z OO 1 ���TNES URYERS 4 SO <br /> VEtJTILATION FAN <br /> URiNAL - <br /> RANGEHOOD <br /> DflINKING FOUNTAIN C.F.M. <br /> AIR HANDLING UNIT— <br /> FLOOR DRAIN S <br /> STOVE —WOOD <br /> VALUUM OREAKERS <br /> METAL FIREPLACE 8 CHIMNEV <br /> ROOF DRAINS— RAINLEADERS FIREPLACEINSERT <br /> SINK ISERVICE — BAR,ETC.) <br /> HEAT PUMP <br /> SUB TOTAL f 12 00 SUBTOTAL f 1S 00 <br /> PERMIT s <br /> PERMIT S 7pip�FEE f 1S OO <br /> TOTAI FEE f S2 OO p�qN CHECK FEE <br /> SIDE VARD SETEAGK STREET SETBACK REAR YAR�SETBACK PLAN 83�12995 ER FEE 87.43 RECEIPT NO. <br /> 64751 _ <br /> USE ZONE LOT AREA VACANT SI7E FEES VALUATION FEE _ <br /> $_2 :lYES X7�0 <br /> 7YPE OF CONST. OCCUPANCY GAOUP NO.OF DWELi NG UNITS <br /> V-N R-3 BUIIDING s 19,000. 134 50 I <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD pLUMBING 1Z OO <br /> 1 j <br /> FIRE ZONE BASEMENT FIHE SPRINKLERS MECHANICAL LS OO � <br /> REOUIPED <br /> NOttG. , �.YES i�-NO OTMER <br /> APPHOVALS BY DATE I <br /> U.B.G. <br /> t ENVIflONMENTAI CHECN LIST PENALTY SEC.303(e) � <br /> p.O111L01NG PLANS 161 5� � <br /> TOTAL <br /> 3.FIRE HVDRANT <br /> PERMIT VALIOATION <br /> 4.FIRE PFOTEC110N SYSTE 1AW �NEN qp�p�pl y VALI�A ED(M T�5=S,PAaCE)TMI$I�YOIfR PEROMIT L'+ <br /> 5.GRADI NG <br /> N tJ 1 L UU � [ p SY 5 <br /> � i <br /> 6.ORAINAGE � � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT ��,` <br /> B�EALTHDISiRICT. � �� �- ��� � RtCEIPT ;'O�U R RECEIPT ' ' ; <br /> qPPLICATION AC(?.BY 7 NS CHECKED BY APPR.FOR ISSUANCE BY J �� „� Y�� � 'i f-f A f�!K Y O U <br /> � �� �.7 w HWM LC � � � , <br /> � EH�,� . .. <br /> 0 <br /> I �N ��� �., I Z I c�r 8 3 1 � ocr 8 3 <br /> G � ADDRESS FILE � <br /> � . <br /> . <br />