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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 <br />' CONSTRUCTI" <br />PERMIT <br />❑ COMBINATION G�XBUILDING ❑ MECHANICAL <br />PERMIT NO. 13757 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Charles C. Allen 2318 2nd Avenue #765 Seattle 98121 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 4 <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE♦ <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />❑ NEW ❑ ADDITION [ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ W000 STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />$ 3.000.00 <br />Rnaair ton apartment <br />PROPOSED USE OF BUILDING <br />tri-flex <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />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 STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNFCONTR TOR ORUTHORDATL <br />8/10/84 <br />C_ <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT_BLOCK_OF <br />UnFlatted SW} 3029 5 <br />— <br />JOB ADDRESS <br />3501 Federal <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />1 <br />WATER CLOSET (TOILET) <br />2 <br />00 <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. N <br />p <br />KITCHEN SINK & DISP. <br />no <br />FORCED AIR SYSTEMS — B.T.U. M EA. !� <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS 2 <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />,VACUUM BREAKERS <br />STOVE — WOOD 3 <br />. <br />:B4OOF DRAINS — RAINLEADEHS <br />METAL FIREPLACE & CHIMNEY <br />i!gNK(SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />d11Yi <br />3Yoid <br />� � <br />I <br />SUB TOTAL <br />$ <br />8 <br />00 <br />SUBTOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />$ <br />8 <br />00 <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />1 <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLI <br />FEE <br />A CHECK FEE <br />RECEIPT NO. <br />USE ZONE j <br />LOT AREA <br />VACANT SITE <br />. YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />s 3,000. <br />38 <br />50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />8 <br />00 <br />FIRE ZONE <br />BASFMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />. YES L�NO <br />MECHANICAL <br />OTHER <br />APPROV'.LS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />46 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIQ181YpUB PI@RMI7 <br />N <br />(Y) <br />i <br />_5.GRADING <br />_C DRAINAGE <br />..j.ENVIRONMENTAL IMPACT$7ATEMENT <br />PB. HEALTHDISTAICT r�o <br />APPLICATION ACC. BY <br />_• <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />C4] <br />ADDRESS FILE <br />