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- . �_ <br /> j <br /> the Erergreen Cr-V ST R U CT I O N <br /> ��,�oF <br /> everett PERMIT p�qMIT (�0. 07195 <br /> GTY HALL 259-8745 <br /> EveaeTr,wn 9ezo� ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNLq MFIlAUD4L55 CIl/ ZIP PMONE <br /> Ruth Hall 2222 Broadway Everett <br /> RnpuTECT OR DESiGNER MFI�ADDRC55 GiiV ZIP PMONE <br /> GEN[RALCONTRACiON MAIL/�DDP[55 p11V ZIP PHONE LIGENSE♦ <br /> Owl Builders 9508 87th N.E. Everett OW I.B V 263CB <br /> I1EC��AWGALCONTRPGIOR MAIIAD�NE55 GtY j�P PNONE IIGENSE♦ <br /> PIUA�BINGCONTRApiOR MAILADDRE55 C17Y ZIP FHOHE LICENSEI <br /> ClA55OF WORK <br /> ❑NEW ❑ADDITION ❑ALTERA7ION �7GiEPAIR ❑DEMOLITION ❑FENCE OSIGN ❑GARAGE <br /> VPWRTION OF WORR <br /> � �.rJ��.�O <br /> DESCRIBE WORN <br /> Insulation of basement and inatall windows <br /> �aorosm use ov ewiuu+c ' <br /> single £amily residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINFG THIS AP- <br /> ucn�oescaivrioN os rnoaearv isHow eeiow oa nnncN voua wriesi PLICATION AND KNOW T�aF $Ab1E TO BE TRUF AND CORRECT. <br /> 21-22 475 Everett ALL PROVISIONS OF LAWS APiD ORDINANCES GOVERNING THIS <br /> �or a�ce�oF TYPE OF WORK WILL 8E COM1�PLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> _ PRESUME TO GIVE AUTHORITY TQ VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER ST OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE RMANCE OF CONSTRUCTION. <br /> JOB NDO SIGN4tURE OF NTRACi P . H IiEO/d T DATE <br /> � <br /> 1�Z�2 Broadway , X �y� � � /� 2/1/80 <br /> i/ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF F.OUIPMENT FEE <br /> WATER CI OSET iTORET) AIR C01JD. UNITS— H P.EA <br /> BATHTUB REFRIGERATION UNIT$—NP.EA <br /> IAVATORY(WASH BASIN� BOILERS—H P F.: <br /> SHOWER GAS FlPEU 0 C UNITS--TONNAGE EA. <br /> KITCHEN SINK 8 DISP. f ONCED AIR SVSTL1d5—B 7L. M EA <br /> DISHWASNEP WP,L HEATENS—�T U. M <br /> LAUNDPY TRAY UNIT HCATERS—0 T U. M <br /> CLOTNES WASH[R FVAPORATIVE CAOL[RS <br /> WAT[R HEATER CL7THES ORVERS <br /> UfiiNAL VENTIL4TION FAN <br /> DRINKING FOUNTAIN RANGE YDOD <br /> �LOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BPEAKERS SiOVE <br /> ROOF DRAINS—RAINLEADERS METAI FIp[P�,4CE B CHIMNEV <br /> SINM,(SCRVICE—BAP,ETC� <br /> SUBTOTAL SUBTOTAL f <br /> PERMIT i l�ERMIT f <br /> TOTALFEE S TOTALFEE S <br /> SIDE YARD SETBACK SiREETSLTBACK FEAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECKFEE <br /> FEE RECEIPf NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> LIVES ❑NO FEES VP.LUATION FEE <br /> TYPE OF CANST. OCGUPAHGY GROUP NO.OF DWELLING UNITS <br /> BUILDING $1500.00 15 00 <br /> SIZE OF BLDG. NO.OF STORIES MA% OCC. LOAD <br /> PLUMBING <br /> FlRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL <br /> I;YE$ 1;NO <br /> APPROVALS BY OATE OTI{ER <br /> �. EHVIRONMENTALCMEGKLIST PENALTV UBC. <br /> 2. DUILDING P�NS SEC.3W(a) <br /> 3. FlRE HVDRqNT TOTAL ZS OO <br /> a. FIRE PROT[CTION SYSTEM PENMIT VALIOATION <br /> 5. GRADING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PER I7 � <br /> 6. DRAINAGE ' 7� 1 J ��� " •O O � � <br /> � . <br /> 7. ENVIRON�tENTAI IMPACTSTATEMENT <br /> 0 HEALTHDISTRIC7 �.�� R pEC.E�� <br /> APPLICATION ACC.BY PLpNS CNECKED BY APPq.FOF ISSUANCE�Y 'p`�{�`�K Y R� <br /> 3 _ <br />