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. <br /> `�Pt�,'�R�o° " r7NSTRUCTION -- '� <br /> everett PERMIT pERMIT N0. OS697 <br /> CITY NALI ?59�8745 <br /> eveaFTT,wa eezo� ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBINCi <br /> UWNkN MMLMIUNl55 VIY LP PNUNt <br /> T. C. Williama 4124 Cliff Drive 98203 258-3288 � <br /> �nCW1ECi OP DCSiuNE11 M�il�UDNE55 CI1Y 21P FrJNE <br /> GChfR1lCONiRACT011 Mql�ppAE55 pfY IiP PNONi 11LEN5C � <br /> Same <br /> uLU1RNIC/1L WNiMC10B M�:l��ORE55 CIiY 21P PNONE UGENSF 1 <br /> PIUMBING CONiR�Ct011 M�II�O�Rf.55 CIIY zIP PNONE IILENSE 1 <br /> CUSSCi WOqN <br /> ❑NEW ❑ADDITION ❑AITERAT10N ❑i1EPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> V�WAIIONOf WpRI( <br /> S <br /> OESC�19E WORN <br /> inatall fireplace insert <br /> rnovoseo use or eunoiHa <br /> ein le famil residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED T1115 AP- <br /> iecn�oescnmrroHormorcnrv�sr�oweaowoee*ucHvouncories PLICATION AND KNOW THE SAME 70 BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVFRNING THIS <br /> ior eix�_or TYPE OF WORK WILL BE COMPUED WITH WHE7NER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORI?Y TO VICLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION Ofi THE PERFORMANCE OF CONSTRUCTION. <br /> ,roe�ooaeas — cicnnro F co +.cioa o �u nveo�cfNr o�rF <br /> tXX 4124 Cliff Drive X ' 12/16/80 <br /> PLUMBINO MECHANIGAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT fEE <br /> WATER CLOSEI(TOILET� AIR COND UNITS— NP.EA _ <br /> BATNTUB fiEFRIGERATION UNITS—H P EA <br /> LAVATORV�WASH BASIN� OOI�EPS�- N P EA <br /> SNOWFN GAS fIRCD nC UNITS—TONNAGE EA <br /> KITCHFN SINK 8 DISP f�ORCCU AIR SV51[MS—B T U M EA <br /> DISHWASMER WALL HEAT[RS— B 7 U M <br /> LAUNDRY TRAY UNIT 1/FATERS—P T U M <br /> CLOTHES WASMER EVAPORATIVLCOOLERS <br /> WATER MEA7CR CIOTHES DPYLRS <br /> URINAL VENIILATION fAN <br /> DRINNING FOUNTAIN RANGE IIpOD <br /> i�LOOR DRAIN AIN HANDIING UNIT— C F M <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEAOER$ MEIAL FIRF.PLACE 6 CHIMNEY <br /> SINK�SERVICE—BAP ETC) 1 Fire .18CE ineert 4 5� <br /> BUB TOTAL SUB TOTAL t S 0 <br /> PERMIT i PERMIT f <br /> TOTALFEE f TOTALFEE f <br /> SIDE VARD SEiBACN STREET SET9ACh REAR YARD SETBACK PIAN CHFCK NUA'BER PLAN CNECN PEE <br /> FEE R[CEIPi NO <br /> USE ZONE LOT AREA VPCANT SITE <br /> I;vES I1N0 FEEB VRLURiION FF.E <br /> TVPE OF CONST. OCCUP�NCV GROUP NO OF CGr��ING UNITS <br /> BUILDING <br /> SIZE OF BLDG NO.OF STORI[S MAX OCC IOAD <br /> PLUMBINQ <br /> FIRE ZONE BASEMENT FIPE SPRINNLERS <br /> REOUIRED MECHANICAL <br /> I)YES 17N0 <br /> APPNOVALB EY D11TE OTHER <br /> I. ENVIRONMEN�4l CNECK IIST PENRLTY U B C <br /> 2 BUIIDINOPLANS SEC.903�e) <br /> 3. FIREMYDMNT TOTAL � SO <br /> a. FIRE PROTFCTION 6YSTEM PERMIT VAIID�TION <br /> 5. ORADING WHEN PROPERIY VALIDATED(IN 1HI5 EIPA��CF�)jJ11S IS��R�M�i 0 _� � <br /> � � ) <br /> 6 DRAINAGE <br /> � <br /> 7. ENVIRONMENTAL IMPACT STATEMENT <br /> B HEALTH�ISTRICT �. � ^, n _C�I PT � <br /> APPLICATION pCC.BY PlANS r,MECNE�BV APPR FOR ISSUANCE BY ' ; • �� ��'� U O <br />' V.C. <br /> � I i�EC 5 0 <br /> ADDRESS FILE <br /> r_ <br />