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rhe E�-rrGreen - �a N ST R U CT i O�' <br /> everett PERMIT PERMITNO. 160 � 1 <br /> GTV HALL 2598745 <br /> Eveaerr. �vnsezai ❑ COMBINATIOP! �i BUILQING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MRILA[IDRE55 GTY ZIP �NONE <br /> Dr. Joseph Welch 9005 Colby Avenue Everett 98201 <br /> APCMrtEGT OF O[S�GNER MA�I ADDRE55 QT` ZIF PHONE <br /> GENERnL CONTNAGTOR MAIL ADDRE55 CITY ZIP PMONE LILENSE i <br /> Gaffney General Contracting Inc. 9502 19th Avenue S.E. Everett 98204 <br /> MEGMRNICA�WNTRRCTOR MA�L AODRE55 LITY 21P FHONE LIGENSE� <br /> PWMBIHG GONiPhGTOR MRIL AODRE55 CIiY ZIP PNONE LICENSE� <br /> GUSS OF WORK <br /> O NEW ❑ ADDITION ❑ ALTERATION ❑REPRIR }�DEMOLITION � fENCE ❑SIGN ❑ WO00 STOVE/FIREPLACE INSEPT <br /> VALURTION OF WORK <br /> f <br /> DESGNIBE WORK <br /> Demolish Single Family Residence <br /> PROPOSE�USE Of 0111LDIkG <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANO <br /> LEGAL DESCP:niION OF PROPERTY�SMOW BELOW OR A11AGN POUR COFIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 5-6 10 Climax Land Co's lst GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �or_u�ocK_oF_._ WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLASE <br /> OF CANCEL TH£ PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGUL�TING COtJSTRUCTION OR THE <br /> P fORMANCE F CONSTRUCTION. <br /> JOB nODPE55 iGN TURE OF GONiN T AVT 12E0 AG�NT DRii <br /> 9009 Colby Aver.ue �' Q - <br /> PLUMBIN6 �AE�ANICAL I � <br /> NO. TYPE OF FIXTURE OR ITEM FEE N6. TYPE OF EOUIPM T FEE <br /> WP,iERCLOSET�TOILET) AIR COND.UNITS — H.P. EA. <br /> BATHTUB RLFRIGERATION UNITS — H.P. EA. <br /> LAJATOflY(VJASM BASIN) BOILERS— H.P. EA. <br /> SNOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITCMEN SINK d DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DIiY.WASHEF WALL HEATERS— B.T.U. M _ <br /> I.F.UND�Y iRAY UNIT HEATERS— B.T U M <br /> CLOTNES wASHER EVhPOPATIVE COOLERS _ <br /> WATER NEATER CLOTHE3 DRVERS _ <br /> :J71NAL �ENTILATI04 FAN <br /> DRINKING FOUNLAIN RANGE HOOD <br /> FLOOR DHAIN AIR HANDLING UNR— QF.M. <br /> VACUUM BFEAKERS STOVE —WOOD <br /> POOF DRAINS— RAINLEADEli3 METAL FIREPLACE 6 CMIMNEY <br /> SINK�SEFVICE — BAR, ETC.) FIPEPLACEINSERT <br /> HEAT PUMP <br /> SUB TOTAL S SUB TOTAL f _ <br /> PERI.IIT f PERMIT i _ <br /> TOTAL FEE f TOTAL FEE f <br /> SIDE YARD SETBACK STREETSETBACK REAR YARD SETBACK PLAN GHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> YES ��NO FEES YAWATION FEE <br /> TYPE OF CONST. OCCUPANCY G;IOUP NO.Of DWELLING UIJITS <br /> BUILDING S 00 00 00 <br /> SIZE OF BLOG. NO.OF STORIES MA%. OCC.lOAO <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLE(iS 'MECMANICAL <br /> REOUIRED <br /> YES NO <br /> APPROVALS BY DATE �THEF <br /> 1.ENYIRONMENiALCHECKLIST PE�A�Ty U.B.C. <br /> SEC.30]lal <br /> 2.BUI�OING PL4K5 <br /> J.FIREHYpflANT T�TA� OO OO <br /> d.FIFE PROiEC�ION SYSTEM PERMIf VALIDATION <br /> 5.GFAOING WHEN PHOPERLY VALIDA7ED IIN TMFS S�6E)THI����S O. O O IT ' � <br /> 6.DRAINAGE <br /> 7.ENVIRONMENTALIMPACTSTATEMENT , . <br /> 8.HEALTH DISTRICT , � � . , . <br /> APPUCATION ACC.BV PLANS CHECKED BY APPP.FORISSUANCE BY � � � �� �� �� I <br /> i <br /> � . _i ., ,i <br /> ACDP��s I ilC <br />