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the EY CITYOF <br />Giv OF <br />-_ CONSTRUCT101 g <br />� <br />,- everett <br />PERMIT <br />PERMIT NO. <br />14813 <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 U <br />COMBINATION ❑ BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />OWIIEPI <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />EVERETT WA 98201 <br />259-2569 <br />ROBERT J. MOORE <br />ARCHITECT OR DESIGNER <br />4121 FFDFRAT <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE N <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE N <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE N <br />yam,. Vr 1 <br />1.�' ❑ NEW R ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />f 15.000.00 <br />_.... <br />1...,.1, ao,-T, Frnnr T,nrrh_ kitchen remodel <br />AUWI - 11VJLILKA , <br />"- - <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />Swalwell's <br />3rd Addn to <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT BLOCK_OF <br />WHETHER SPIECIFIED HEREIN OR NOT. THE GRANTING OF A <br />verett7 <br />PERMIT NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CAN L THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL /LAW REGULATING CONSTRUCTION OR THE <br />PENATURq0IORFONCTRACTE O CONSTRUCTION. <br />SIGNR R AUTHORIZED AGENT DATE <br />- 5/6/85 <br />JOB ADDRESS <br />4121 Federal <br />X <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />- TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <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 />- <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <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 <br />ROOF DRAINS - RAINLEADERS <br />46- <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />ine- <br />HEAT PUMP <br />r-. <br />SUB TOTAL <br />f <br />SUB TOTAL $ <br />PERMIT <br />S <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL FEE S <br />7 <br />ISO <br />SIDE YARD SETBACK STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />1 20' <br />201 <br />85/14813 <br />FEE 71 83 <br />RECEIPT NO. <br />76813 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />YES XI NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$15,000. <br />110 <br />50 <br />V-N <br />R-3 <br />1 <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />10 <br />00 <br />AddTi 7 sf <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />7 <br />50 <br />REQUIRED <br />.YES NO <br />OTHER <br />—� <br />I <br />APPROVALS <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 />128 <br />OO <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPADE) THIS ISIYOUf1 PERMIT-.- In <br />5. GRADING <br />00 <br />1 <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />-8. HEALTH DISTRICT _ <br />APPLICATION ACC.TNS <br />CHECKED BY <br />APPR. FOR ISSUANCE BYstghwm <br />lc <br />z <br />O <br />c•1 <br />m <br />z <br />O <br />--I <br />H-� <br />m <br />m <br />ADDRESS FILE <br />