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f �P�. <br /> � . . . . ' ": �'.� Y � s��:� <br /> the£vCIgTYOF ��✓ONSTRUCTION- ^ <br /> everett PERMIT pERMIT N0. 0�942 <br /> GTY HALL 259�9745 <br /> EVERETT.I4A 98201 ❑ COMBINATION C�gBUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAIL ADDFE55 <br /> CITV ZIP PHONE <br /> Dr. Wm E. Hummell <br /> ARCHITECTORDESIGNCN MAIIADDRE55 CIiY ZIP PMONE <br /> GENEflRLCANiRACiOR MAII AOORE55 <br /> GITY IIP PNONE LICENSE� <br /> Plan Formation 6822 211th Place N.E. Arlington 98223 435-3609 <br /> MCCNANICNLGONTRACTOfl MAILADpFE55 CITV ZIP PHONE LIL[NSE/ <br /> PL AN FV *280QF <br /> VLUMBINGCANTRF�70A MAn.ApDRE55 Cltt ZIP PMONE LICENSE� <br /> ClASSOF WOFK <br /> ❑NEW ❑ADDITION OALTERATION �IEPAIR ❑DEMOLITION �FENCE OSIGN ❑GARAGE <br /> WLUATION OF WOFK <br /> f 5 �5��. �� <br /> DESGRIBE WORN <br /> re-roof over old hot mop <br /> PROPOSED USE OF BWLDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> ICGALDESGRiPIpNOFPROPERTY�SHOWUELOWONATTACHFOURCqPIES) PLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT. <br /> 31-32 420 EveYett Div. "K" ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ioT eioc�oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEHEIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> � PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> J09 ADDRESS SIGNAiUpE OF�pNTRACTOF OR A IMOH12E�AGENi DATE <br /> 2002 Broadway i� � � <br /> '� '.��(�� .�_ � io z6 ai <br /> PLUMBING HANICAL <br /> N0. TYPE OF fIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATEF CLOSET(TOILET Alq COIJD.UNITS—H P.EA. <br /> 6ATHTUB REFRIGERATION UNITS—H P.EA <br /> LAVATORV(WASH BASIN) pOILERS—H.P.EA. <br /> SHOWEF GAS FIRED AC.UNITS—TONNAGE EA. <br /> _ KITCHEN SINK 8 DISP. FORCED AIP SYSTEMS—B T.U. M EA. <br /> � . DISHWASHER WALL FIEATERS—�T.U. M <br /> �.'' ��i � . . LAUNDRY TRAV UNIT NEATE�S—O.T.U. M <br /> ��i�%�� . �, . � � CLOTHES WASHER EVAPOIIATIVE CACLERS <br /> _ _ . WATER HCATER CLOTHfS DRVERS <br /> . ,�'�•'".�' � ' - � UHINAL VENTILITION FAN <br /> ., ' � ' � DRIIJKIWG FOUNTAtN RPNGE HOOD <br /> ,� � ' � � FLOOR�RAIIJ AIFl HA�JDLING UNIT— C F M. <br /> VACUUM�REAKERS STOVE <br /> � � � � ROOFDRAINS—flAWLEADERS ME7AI,=iPEPLACEBCNIMNEY <br /> i . � SINK(SERVICE—l3AR.ETC� <br /> SUBTOTAL SU970TAL f <br /> _ PERMIT f PERMIT S <br /> TOTAL FEE S TOTAL FEE f <br /> SIDE YARD SETBACK STfiEET SETBACK REAH VARD SETBACK PLAN CHECK Nl1MBER P�qN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACAN7 SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING 5500.00 56 $0 <br /> SIZE OF BLDG. NO.OF STOHIES MA%.OCC.LOAD <br /> PLUMBING <br /> _hn �: FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> Ltld� �� REOUIRED MECHANICAL <br /> `i ; ' ❑YES ClNO <br /> ' `^�� �"= APPROVALS BY OATE OTHE(i <br /> � '",�7�! � 1. ENVIRONMENTALCHECKLIST <br /> �� :{ . <br /> �':y.,`.•,-,. . . PENAITY UBC. <br /> ic <br /> , , � - 2. BUILDING PLANS SEC.303(e) <br /> i�� � . 3. FIRE NYDRANT TOTAL S 6 S 0 <br /> � � 4. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> 5. GRADING <br /> WHEN PROPERLV VALIDATED(W THIS SPACE)THIS IS YOUR PERMIT <br /> G. DRAINAGE �. ` r � ^ ' � /. �' � —.-- � <br /> I' <br /> 7. ENVIRONMENTALIMPACTSTATEMENT � <br />� 8. HEALTH DISTpICT � <br /> APPLICATION ACC.DY PLANS CHECKED BY APPR.FOR ISSUANCE OY � i� � <br />