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r .l <br /> 1he Erergreen �`0 N ST R U CTI O N - � <br /> CITY OF <br /> everett PERMIT pERMIT NO. 1O4•HH <br /> CITY HALL 259�B745 <br /> eveaert.wn 9eze� ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ,� <br /> OWNER N41lR�ORE55 OiY 2iV oMCNE <br /> William F. Royce 3223 Wetmore Fveratt 98201 252-6165 <br /> ARCHITECTORDEGIGN:F MRILApDAE55 CfY ZIF MONE <br /> GENERRL fANTFAGTOR MAiL ADDRESS QTY ZIF PH�NE IiCENSE� <br /> Same <br /> t�. <br /> MECHFNICFL CONT{NGTOR MRIL AD�RE55 CITY 21P PHONE �ICENSE I � <br /> 1 <br /> PLUMBING LONTRACiOR MAIL ADDRE55 CITV 2iP �HONE UCENSE/ <br /> GLASS OF WOVK <br /> ❑NEW ❑ADDIiION ❑ALTERATION ❑flEPAIR �EMOLITION ❑FENCE ❑SIGN ❑CFRAGE <br /> '/AWATION OF WORK <br /> S <br /> DESCRi9E WORK <br /> Demolish single family residence <br /> PROPOSED USE OF BW LDiNG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> iecA�oeseaivrioNoveaoPear.,s�owee�owoannneHrouaeonesr PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 24 76 Everett Land Co. ALLPROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS <br /> ioT u�a�o� TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NO1' <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTHUCTION. <br /> JOB ADDRE55 5h'wNnTUWE OF�ONiM *OR OA AUTHOR EO AGE� UnTE <br /> 3216 Broadway X � 4/23/82 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILE� AIR CAND.UNIiS—H P.Eh. <br /> BAiHTUB REFRIGERATION UNITS—H P.EA <br /> LAVATORY(WASFI BASIN) BOILERS—HP.EA. <br /> SHOWER GAS FIRED AC.UNITS—TONNAGE EA. <br /> NITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.TL. M EA. <br /> DISHVlASHER WALLHEATERS—BT.U. M I <br /> LAUNDRV TRAY UNIT HEATERS—B.i.U. M <br /> CLOTHES WASNER EVAPORATNECOOLERS <br /> WAT[R NEATER CLOTHES DRYERS <br /> URINAL VENiILATION FAN � <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOP DRAIN AIR HAIIDLING UNIT— C F.M. � <br /> VACUUM BREAKERS STOVE � <br /> ROOF DPFMS—RAINLEADERS METAL FIREPL4CE 8 CHIMNEY � <br /> SMK�SERVICE—BAq,EfC.) <br /> � <br /> SUBTOTAL SUBTOTAL f ' <br /> � PERMIT f PERMIT f <br /> TOTAL FEE f TOTAL FEE f � <br /> SIDE VARD SEiBAGK STREET SETBACK REAR VARD SETBACK PLAN CHECK IIUMBER PU+IJ CHECK FEE <br /> FLE RECEIPT NO. I <br /> USE ZOIJE LOT AREA VACANT SITE <br /> �:7YE5 CNO FEES VALUATION FEE <br /> TVPE OF fANST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING E 00 00 <br /> SIZE OF OLDG NC.OF STOPIES MAY,.OCC LOAD -- <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> � REOUIFEO M[CHANILAL �- <br /> r-yE5 ❑NO <br /> APPROVALS BY OA7E O7NER <br /> 1. ENVIR9NMENTAL CHECK LIST PENALTY U B C. <br /> SEC.3031a) <br /> 2. BUIL�ING PLANS — <br /> 3. FIREHYDRANT TOTAL OO OO <br /> I a. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLV VALIDATED(IN iM15 SPACE)THIS 15 YOUR FERMIT I <br /> 5 GFADING <br /> n /� � <br /> 6 DRAINAGE I � � E S �% � S7. O O �� <br /> Z ENVIRONMENTALIMPAGTSTATEMENT <br /> 8. HEALTH DIBTRICT � <br /> APPLICATION ACC.BY PIANS CHECKEO BY APPR.FOR ISSUANCE BV YO U R REC E I PT� <br /> TIiANK Y�7U <br /> ADDRESS FILE 2 3 ��PR R1 <br /> . � <br />