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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />C^NSTRUCTION <br />PERMIT <br />❑ COMBINATION BUILDING i 1 MECHANICAL <br />PERMIT NO. 00643 <br />11 PLUMBING <br />OWNER <br />MAIL ADDRESS <br />LUy <br />98201 <br />RHG { <br />Everett school Diet N2 <br />_ <br />ARGHRECT OR DESIGNER <br />4AIl ADDPE65 <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CT' <br />ZIP <br />98206 <br />PNONF LICENEf I <br />259-7257 <br />C, Walter smith Roofing <br />P.O. Box 929 <br />Everett <br />— <br />MAIL ADDRESS <br />GIY <br />Er <br />PHONE LICENSED <br />MECHANK'AL COMPACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PRUNE -- LK;ENSE D <br />PLUMBING COMPACTOR <br />CUSSOF WORK <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑FENCE El SIGN ❑CLARAGE --- <br />VALUATION OF WORM <br />T 289,000.00 — <br />DESCRIBE WORK <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CCRRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DE6CRIPI ION OF MPE RTY(SHOW BELOW OR ATACH FOUR COMESI <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT BLOCK__OF <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DCi:S NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW RFGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGN ATURI. O' CONTRACTOR CA AU ZED JOIN DATE <br />Syr 8/13/81 <br />AB ADDRESS <br />801 Camino Road <br />lL„7� <br />X <br />MECHANICAL <br />PLUMBING <br />FEE <br />NO. <br />TYPE OF EOUIPMFNT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />AIR COND. UNITS — H P. EA <br />WATER CLOSET(TOILET) <br />REFRIGERATION UNITS — M.P. EA <br />BATHTUB <br />BOILERS — H.P. EA. <br />LAVATORY ASH SIUSINJ <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />SHOWER <br />FORCED AIR SYSTEMS —BTU. M EA. <br />KITCHEN SINK 8 DISP. <br />WALL HEATERS — B T.U. M <br />DISHWASHER <br />UNIT HEATERS — P `.U. IA <br />LAUNDRY TRAY_ <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />CLOTHES ON ERS <br />WATER HEATER <br />FAN <br />ON FAN <br />URINAL <br />RANGE H <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT — C F M <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />ROOF DRA'NS — RA.MLEADERS <br />SINK (SERVICE — BAR. ETC ) <br />SUO TOTAL <br />BUD TOTAL <br />V <br />PERMIT <br />t <br />TOTAL <br />TOTAL FEE <br />TA FEE <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />RECEIPT NO <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />FEE <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DES <br />VALUATION <br />FEE <br />❑VEB ❑NO <br />— <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO OF DWELLING HUTS <br />BUILDING <br />T <br />908 <br />00 <br />SIZE OF BLDG <br />NO. OF STORIES <br />MAX DOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />REOU IRE RED NLERS <br />MECHANICAL <br />_ <br />EIYES LINO <br />PENALTY <br />UBC <br />SEC. xO IBA <br />PPROVALS <br />DATEOTHER <br />_DY <br />I ENVIAL CHECK LIST .. <br />2 BUILNS <br />908 00 <br />TOTAL <br />S. FIRE4. <br />FIREION SYSTEM <br />jW <br />PERMITALIDATIONWHENPROPERLY VALIOAlEO (IN THI68PACE)f HIS I6'OUR P(RMIT <br />5GRA6 <br />DRA7. <br />ENVIAL IMPACT STATEMENT <br />Q <br />8 HEAICT <br />CAPPLICC. <br />BY PUNS CHECKED BV <br />APPR FOR ISSUANCE BY <br />' J <br />L.C. <br />a t I <br />ADDRESS FILE <br />