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; <br /> _ <br /> llic E:rr.�reen <br /> �=�r� °F '�-� -�ONSTRUCTION°� �� <br /> everett PERMIT PERMITNO. 1324 �� <br /> CITV MALL 259�8745 <br /> EVEFET'i,WAu8201 � COMBINATION �( BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> Ol9�:EF M�ILADORE55 GIiV ZiP PHOK[ <br /> PAl1L BRUGGAMAN PO 30r 1Fay EVFRFTT WA qR9na ?Fq-�7 <br /> RqCMREGT OF OEEiGNEP MRIL ADORE55 pTY IIP PHONE <br /> GENERAL CONTRACTOR MFIL AODPE55 �ITY 21P PHONE LICENSE� <br /> SUMMIT WESTERN 3018 RUCKER EVERPTr WA 98701 2�Q-am7 SIIMMIW* oln6 <br /> MECMRNICAL GONTqAGTOR MAIL AO�RE55 GTY ZIP pHONE � LIGCNSE M <br /> PLUMBING fANTRACTOR MAIL AOORE55 QTY 21P PHONE UCENSE� <br /> CLA55 OF WORN <br /> ❑NEW �ADDITION ❑ ALTERAiION ❑REPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSEPT <br /> VALUATION OF WORN <br /> s a000.ao <br /> OESCRIBE WORR <br /> Add mansard roof to existin structure <br /> PPOPOSED 115E OF BUILOIN� <br /> Offl C2 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATfON AND KNOW THE SAME TO BE TRUE AND <br /> �t.AL DESCRiPTION OF PRO�EBTV�SNOW BEIOW ON ATTAGN FOUR COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> io�3&24B�ocK 561 oF Ruckers 1 St Pl dt 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 AUTHORIIY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br />�I PEFiF MANC OF CO STRU TION. <br /> J06 ADONESS S�GNAT OF ON AGTOR AUTNORI2E AGENT p4TE <br /> 2520 Colb X <br /> PLUMBING MECMANICAL <br />�� NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF EOUiPMENT FEE <br /> WATER CLOSET�TOILET) AIR CUND.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> L4VATORV(1NASH BASIN� BOIlERS— H.P.E4. <br />� SHOVJER _ GAS FIRED A.C.UNITS— TONNAGE EA. <br /> i KITCHEN SINK 8 DISP. FOflCED AIfl SYSTEMS— B.T.U. M EA. <br /> DISHWASMER WALL HEATERS— B.T.U. M <br /> � LAUNDRYTRAV UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER IiEATER CLOTMES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN qANGE H00� <br /> FLOOR DHAIN AIR HANDLWCa UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIqEPLAGE 8 CMIMNEV <br /> SINK BcRVICE — BAF,BTG) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL S S118 TOTAL f <br /> PERMIT f PERMIT S <br /> TOTAL FEE f TOTAL FEE S <br /> SIDE YARD SETBACK STREET SETBACK REAR YARO SETBACK PLAN CHECK NUMBEfl PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AflEA VACANT SITE <br /> I.VES �.-,NO FEES VALUATION FEE <br /> TVPE OF CONS7. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDINO s4000.00 44 50 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOA� <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> �:VES � ��NO <br /> APPROVALS BY DATE O7HER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U B.C. <br /> 2.BUILDING PLANS SEC.303(a) <br /> 3.PIRE NYDRANT TOTAL 44 5� <br /> a.FIRE PRGTEC7ION SYSTEM pERId17 VALIOATION <br /> 5.GRADiNG WHEN PROPERLV VALIDATED(IN THISOS�AGE1 THIS 1¢YpURIPERA�t_—" �.1 , <br /> 6.DAAINAGE J ES b U 9 9 ) <br /> 7.ENVIRONMENTALIMPACTSTATEMENT • <br /> 8.HCALTH DISTRICT . � ' ^ �'.��'J I f <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR. FOR ISSUANCE BY � ' �� � ' <br /> i.� <br /> stg jef lnc <br /> ' ; . .� � i <br /> ADDRE55 PILE <br /> � <br /> �� d - <br />