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r <br />°i." <br /> � <br /> �ke E��er�;reen <br /> CITYOF �-�-� ;ONSTRUCTic.� �`�� <br /> �verett PERMIT PERMIT �10. 12107 <br /> CITY HALL 259�8745 <br /> EVERET7,WA98201 � COMBINATION � BUILDING L� MECHANICAL }� PLUMBING <br /> OWNEF MAILAO�RESS CITY ZIP PMONE <br /> Edward E. Barthel 3401 Rucker ;�2 Everatt 98201 252-5352 <br /> ARCMITECT OR OESIGNEfl MAIL AOORESS CITY ZIP PHONE <br /> CENERnLCONTRAQOR MAILAODflESS GITY ZIP PMONE LIGENSE� <br /> Same <br /> MECMANICPL CONTRACTOR MAIL AD�RE55 CITY ZIP PMONE LILENSE N <br /> PLUM�ING CONTRACTOR MAIL ADORESS CITY ZIP �HONE LICENSE M <br /> CLASS OF WOPK <br /> ❑ NEW O ADDITION XX ALTERATION ❑REPAIR � DEMOLITION ❑ FEN(:E ❑ SIGN i] WOOD STOVEIFIHEPLACE INSERT <br /> VALUATION OF WOflK ' <br /> S 6 , 000„00 <br /> DESCRIBE WORK <br /> Remodel existing building <br /> PROPoSEO USE OF BUILOING <br /> dance hall I HEREBY CERTIFYTHAT I HAVE READ AND EXAMINEDTHIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> IEGAL�ESCRIPTiONOFPROPERTY�5MOW6EL0190RATfACMFOIIRCO�IES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> L0T_BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANC OF CONSTRU ION. <br /> JO�ADDRESS SIGNATUR FCONT FCT IMORI AGFNT DATE <br /> 4610 Evergreen Way #1 X o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE HO. TYPE OF EQUIPMENT FEE <br /> ¢ WATERCLOSET(TOILEn AIR COND. UNITS — H.P. EA. <br /> � BATHTUB REFFIGERA710N UNITS— H.P. EA. <br /> 1 u+�ATORYIWASH BASIN) 001LER5 — H.P. EA. <br /> SHOWEF GAS FIFED A.C.UNITS —TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.7.U. M EA. <br /> DISHWASHER VJALL HEATERS— B.T.U. M <br /> LAUNORYTRAY UNI7 HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEFS <br /> WATER HEATER CLOTHES DFVERS <br /> 2 URINAL 3 VENTI�ATION FAN <br /> 1 DRINKIfJG FOUN7AIN z RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAHERS STOVE—WOOD , <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE&CHIMNEY <br /> 1 SINK(SERVICE— BAR.EfG) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL f SUB TOTAL S 9 00 <br /> PERMIT S PEHMI7 S <br /> � TOTAL FEE S TOTAL FEE 5 9 0 O <br /> SIDE YARD SETBACK STREETSETBACK REAR YAFD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 83/12107 FEE 36 . 73 g�c�i�9No. <br /> USE ZONE LOT AREA VACANT SITE <br /> �-:YES ^_`!O FEES VpLUATION FEE <br /> TYPE Of CONST. OCCUPANGV GROUP NO.OF OWELLWG UNITS <br /> BUI�_DING S , 000. $6 50 <br /> SIZE OF BL�G. NO.OF STORIES MF%.OCC. LOAD <br /> PLUMBING 18 00 <br /> FIRE ZONE BASEMENT FIRESPRINKLERS MECHANICAL <br /> REOUIRED 9 00 <br /> i�YES ❑NO <br /> APPpOVALS BY DATE �THER <br /> 1.ENVIRONMENTAL CHECK LIST pENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLANS o0 <br /> 3.FIRE HVDRANT "' TOTAL 8 3 S O <br /> 4.FIREPROTECTIONSYSTEM p. PERMITVALIDATtON � � � <br /> 5.GRADING _ WHEN PROPERLY VALIDATED QN THIAS$P�QE)THI��Y@U�1.F�Fj7�11T � � <br /> iS3 6 7b 7U <br /> 6.DRAINPCiE ....' .- Q ! O I S. 00 �� <br /> 7.ENVIROPiMENTAL IMPAG�.STAfEM�NJ 3 � <br /> . N <br /> 8.HEALTH..pISTRICT,' o YO.0 R REC E I PT .-+ <br /> APPLICAAON ACC.BV� ^'PLANS CiRECKED BY APPR. FOR ISSUANCE BY � . <br /> �rrc T' gxs nAs ��n �� Z (�ECEIP7 7f-!AP.K YOU <br /> w � `� o <br /> Q -n 7i-�. .!�l� YOU , • <br /> �' � 21 �u83 <br /> � p'�rEs��li����j 1 <br />