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the £ ergY°n PONSTRUCTION' <br />everett PERMIT PERMIT NO. 16309 <br />CITY HALL 2598745 <br />EVEPETT, WA 98201 ❑ COMBINATION BUILDING rj MECHANICAL i i PLUMBING <br />OWNER MAIL ADDRESS CITY "P PHONE <br />Mabel D. Van Patten 3601 Hoyt Everett, tVA 98201 252-9697 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENtRAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE A <br />Chris Hyde <br />3601 Hoyt Everett, WA <br />98201 <br />89 KMx <br />252-9697 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE F <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />I.P <br />PHONE LICENSE A <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION L7 FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />$4500.00 <br />Re -roof and replace skirting <br />Private home - single family <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIESI <br />LOT .. RLOCK _OF <br />JOB ADDRESS <br />2413 Chestnut <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHOR17ED AGENT OATS <br />X 3/25/86 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS - H.P. EA. <br />13ATHTUB <br />REFRIGERATION UNITS - M.P. EA. <br />LAVATORY (WASH BASINI <br />BOILERS - H.P. EA. <br />_ <br />SHOWER <br />GAS FIRED A . UNITS - TONNAGE EA. <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - 8.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE CCOLERS <br />WATER HEATER <br />I <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />_ <br />SINK (SERVICE - BAR, ETC) <br />FIREPLACE INSERT <br />MEAT PUMP <br />SUBTOTAL $ <br />SUBTOTAL f <br />PERMIT S <br />PERMIT f <br />TOTAL FEE f <br />I <br />I TOTAL FEE % <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />N0. OF OWELLING UNITS <br />BUILDING <br />! 4500.00 <br />SO <br />SO <br />SIZE OF BLDG. <br />NO OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />OTHER <br />— <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B.0 <br />SEC. 303 (A) <br />2, BUILDING PLANS <br />TOTAL <br />_ <br />5O <br />50 <br />3. FIRE HYDRANT <br />1. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IIN TMI$ SPAT THIS�yS ftb P"IT_ <br />I y 7 ' <br />`,, `j1n RLn E'nT�; <br />'` 1. 1 1 <br />.I. �r L~U <br />�. <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />M.M. <br />PLANS CHECKED BV <br />APPR. FOR ISSUANCE BY <br />L. C. <br />2 5 WR 86 <br />ADDRESS FILE <br />