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I <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />''ONSTRUCTION <br />PERMIT <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />PERMIT NO. 13823 <br />❑ PLUMBING <br />OWNER <br />MAIL AUDRESS <br />4526 Federal <br />CITY <br />Everett <br />ZIP <br />98201 <br />PHONE <br />258-2371 <br />Luther Child Center <br />CITY <br />IF <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P <br />98203 <br />PHONE LICENSE N <br />353-2331 <br />Solie Builders, Inc. <br />7514 Juniper Dr. <br />Everett <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE N <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N <br />cuss ur ..ann <br />❑ NEW ❑ADDITION ❑ ALTERATION D➢ REPAIR El DEMOLITION ❑FENCE ❑SIGN ❑ WOOD STOVEIFIREPLACEZNSERT <br />$ 11 , DUD <br />DESCRIBE WORK <br />....4 nii+ nn now rnnf_ inculati On & new plywood sheathing <br />I c,a. V I I , .. ..... ....' _ _ <br />_ <br />PROPOSED USE OF BUILDING <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 />LEGAL DESCRWTIONOF PROPERTY (SMOW BELOW OR ATTACH FOUR CC PIES) <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT_BLOCK___OF <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 />0 NA <br />LOCAL LAW REGULATING CTRUCTION OR THE <br />PERF AN OF TRUCTI <br />SIGNA RE F C TRA RA IZE F $ DATE <br />84 <br />JOB ADDRESS <br />4526 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 />SHOWER <br />GAS FIRED A.G. UNITS — TONNAGE EA. <br />— <br />KITCHEN SINK & DISP. <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 <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLI14G UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />S <br />SUB TOTAL $ <br />PERMIT <br />S <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />86 <br />0 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />i : YES - NO <br />TYPE OF CONST. <br />OCCUPANCIGROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S 11 000. <br />86 <br />50 <br />SIZE OF BLDG. <br />N0. OF STORIES <br />MAX. OCC. LOAD <br />— <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />REOUIRED <br />YES ONO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.G. <br />SEC. 303 (a) <br />_ <br />2. BUILDING PLANS — <br />TOTAL <br />86 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTE"A <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS t9RA;E) THIS'ISIYgU/i FjEF)MIT <br />5. SHADING <br />t I IJ bb 7 �j OC <br />c; <br />] p <br />:i ;`-CF'�PTIAPPLICATIONCHECKED <br />• <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />BY <br />APPR. FOR ISSUANCE BY <br />=BYPLANS <br />DB <br />2 g ;uG 0 4 <br />Z <br />0 <br />f') <br />m <br />—I T <br />N m <br />m <br />co <br />FIT o <br />c) c <br />O m <br />--I Z <br />m I <br />m <br />oz <br />Lm <br />D � <br />O A <br />m ' <br />—I m <br />2 <br />M <br />o m <br />nm <br />C Ln <br />N <br />m <br />Z C') <br />—I m <br />• m <br />a <br />A <br />ADDRESS FILE <br />