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the Evergreen CONSTRUCTION e v e re tt <br />CITY GF PERMIT <br />eve rett <br />CITY HALL :59874h <br />EVERETT, WA BB20I COMBINATION • BUILDING • MECHANICAL • PLUMBING �e <br />OWNER MA ADDHI!tb /w <br />Twn le Baptist Church #1 West Casino Road 98203 775_7434 <br />V <br />m <br />ARCHITECT OR DESIGNER MAIL AUORESS PHONE LICLN':L Nu <br />3 <br />Z <br />05 C <br />ca <br />� m <br />GENERAL CON7 RACTGR MAIL ADDRESS PHONE LICENSE NO. <br />Spane Buildings 27004 64th Aven N.W. Stanwood Wa. 629-2136 223-01- <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHGNE LICENSE NO. <br />PLUMBINC :ONTRACTOR MAIL ADURESS PHONE LICENSE NO. <br />00 <br />PERMIT <br />❑ CO 1.I0 IN ATOO N <br />BDUILDING []PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITIGN ❑ALTERATION ❑Rf PAIR <br />CD <br />VALUATION OF WORK <br />$ 40000.00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />Construct 20'x301 building <br />PROPOSED USE <br />storage <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />FLDESCRIIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />OUR <br />Lot BLOCK —.OF <br />Section 17 Twp 28 R9 e 4 EW <br />L F <br />TYPEEQUIPMENT <br />FEE <br />AIR COND. UNITS-M.P. EA. <br />—� <br />REFRIGER ATION UNITS-H.P. EA. <br />_ <br />BOILERS-H.P. EA. <br />1 <br />FORCED AIH SYSTEMS-B.T.U. MEA. <br />_ <br />— 1 <br />JOB ADDRESS <br /># 1 West Casino Road <br />SPACE a WALL HEATERS - B.T.U. <br />UNIT HEATERS A.T.U. <br />1 <br />EVAPORATIVE COOLERS <br />I <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTIL^TION FAN <br />RANGF HOOD ---_--- _--- I <br />AIR HANDLING UNi I -C.F.M. <br />--- -- ----- _ _ I <br />WATFH 11FATER <br />I AC Hun I 1 IRFPL ACI ee CHIMNEY I <br />(;A, ;:v STT M No GP OUTLETS _ <br />SUB TOTAL S <br />�— <br />PERMIT $ <br />TOTAL FEE S I <br />T111`t PERMIT BECOMES NUI L AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMCNCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HERF'. BY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME To <br />GIVE AUTHORITY TO VIOLATE On CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGUI. ATING CONSTRUCTION <br />OR THE Pt RFORMANCE OF CONSTRUCTION. <br />�i <br />� Li 1L (J �`7 <br />:_XS:4A: <br />GFC NTRACTOR AUTH. AGENt DAT/�SIDE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />BATH TUBS <br />CLOTHES WASHER <br />DISH WASHERS <br />I <br />DRINKING FOUNTAINS <br />FLOOR DRAINS <br />KITCHEN SINKS <br />BAR SINKS <br />ROOF DRAINS - RAIN LEADTRS <br />SHOWER OATHS <br />SERVICE SINKS <br />SUMPS SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />II <br />WATER HEATERS - EL_LI:TRIC <br />WAS'; BASINS <br />1 <br />_ _ <br />LAUNDRY TRAYS <br />- <br />— <br />1 <br />_ <br />_—. <br />SUB TOTAL <br />PERMIT- <br />STOTAL <br />FEE <br />WATER <br />SERVICE SIZE BU)G. SUPPLY <br />SIZE <br />YARD SETBACK <br />STREET SETBACK REAR <br />YARDSETBAC <br />K NUMBER <br />78/515 <br />PLAN CHECK FEE <br />FEE 14.00 RECEIPT NO. <br />32815 <br />_ <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO.OF <br />UNITS <br />DWEL ING <br />I <br />BUILDING <br />S 4 GOO. OO <br />28 1 00 <br />SIZE OF Bt-DG. <br />_ <br />NO.OF STORIES MAX. <br />OCC. 1 OAD <br />PLUMBING <br />1 <br />FIRE ZONEBA <br />1WF1 <br />REQUIRED <br />IRES I K 5 <br />DYES ONO <br />—_—_— <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS'. <br />OTHER <br />_ ----- <br />PENALTY <br />SEC. :03l.0 <br />I <br />TOTAL <br />28 100 <br />PERMIT VALIDATION 1°��tiM1� <br />WIIL N PROPE OIL Y VAL IUAI F D II I PAC H <br />YOUR RECEI <br />THANK 1`01,1 <br />, <br />1 R AlC 79 <br />---- — — -- <br />— - -- - <br />— <br />AFPLICAIIONACCIHHIXY <br />— <br />vl At6l."tCAHIxY AR'11UV111 <br />IIN 165On4 <br />VII I <br />