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rhe Evergreen ��������'0� <br /> rr, -_, ^ <br /> CITY OF <br /> everett PERMIT PERM�T No. 157sa � <br /> GTY HALL 259-8745 k <br /> EVERETT,WA 98201 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING j <br /> i <br /> OWNER MRIL AODRE55 CITY 21P PMONE � <br /> Pignataro 10520 Evergreen Way Everett <br /> �RGMITECT OR DESIGNER MAIL A�DRE55 CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDFESS CITY ZIP PHONE LICENSE I <br /> MEGM�NIC�L CONTR�CTOR MAIL ADDRE55 CITV 21P PNONE UCENSE� <br /> Lynnwood Electric P.O. Box 2356 Lynnwood 774-2021 <br /> PLUMBING CANTNAGTOR MAIL ADOflE55 CITV ZIP PHONE LICENSE I <br /> CLA55 OF WONK <br /> ❑ NEW ❑ ADDITION O AITERATION ❑H::PAIR ❑ DEMOLITION ❑ FENCE � SIGN ❑ WOOD S70VE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> S <br /> DESCRIBE WORN <br /> PROPOSEO USE OF BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPfION OF PROPERTY�SMOW BELOW OR ATfACH FOIIR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> UtT_BLOCN_OF 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 STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CO T ION. <br /> JOB AUDRESS SIGNATU F CO F T R A M E AGENT �ATE <br /> 10520 Evergreen Way X 12/9/85 <br /> PLUMBING MEC ICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WA7ERCLOSET�TOILE� " AIR COND. UNITS— H.P.EA. <br /> BATHTUB REFRIGERATION UNI7S— H.P.EA. <br /> LAVATORY(WASH BASIN) 801LERS— H.P. EA. <br /> SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B,T.U. M EA. <br /> DISHWASHEfi WALL HEATERS— B.T.U. M <br /> LAUNORY TRAY UNI7 HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES ORYEFS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HG�D <br /> FLOOR DRAIN AIP HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS S70VE—W!10D <br /> ROOF ORAINS— RAINLEADEFiS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SEFVICE— BAR,ETQ) FIREPLACEINSERT <br /> HEAT PUMP <br /> SUB TOTAL i SUB TOTAL S lg <br /> PERMIT f PEFMI7 S <br /> TOTAL FEE S TOTALFEE S <br /> SIDE YARD SETBACK S7REETSETBACK HEAR YARD SETBACK PLAN GHECK NUMBER PLAN CHECK FEE <br /> FEE RcCEIPT NO. <br /> USE ZONE LOT AREA VACANT SI7E — <br /> :7YES ;:NO FEES VALUATION FEE <br /> NPF.OF COPIS7. OCCUPANCY GROUP NO.OF DWELLING UNI7S <br /> BUILDING S <br /> SIZE OF 2LDG. NO. OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE 20NE BASEMEN7 FIRE SPRINKLERS MECHANICAL 28 00 <br /> REOUIRED <br /> VES �NO <br /> APPNOVALS BY DATE 0T4ER <br /> 1.ENJIRONMENTAL CHECK LIST PENAL7Y U.B.C. <br /> SEC.30J(a) <br /> 2.BUILDING PLANS <br /> 3.FIREHYDRANf TOTAL 28 OO <br /> 4.FIfiE PRO?ECTION SVSTEM PERMIT VALIDATION <br /> 5.GRADING �NHEN PROPERL�VALIDATE�(IN THtS�M�E)THI9�1S1Y9UR RERNIT -:l} <br /> � b U 0 V U /gi� <br /> 6.ORAINAGE <br /> ��` <br /> 7.ENVIRONMeN7ALIMP:�CTSTATEMENT � <br /> B.HEALTHDISTRICT ' . �. . . � ' I � <br /> ! ii <br /> APPLICATION ACC. BY PLANS CHECKED Br APPF. FOR ISSUANCE BY <br /> ., . . . � . . � �.� <br /> — � : _� U� <br /> ADDRESS rILE <br />