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0 <br />APPLICATION FOk% <br />the EvsrprNn everetl <br />CITTDF CONSTRUCTION liml <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK — PLEASE PRINT <br />BUILDING DEPT. <br />259-8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILADORESS CITY ZIP PHONE <br />�i0 HT_1ATY J014W I%�0 -I F-RRACEF ANCAAO ISH 922M &cR-50M <br />ARCHUECTORDESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE♦ <br />LICENSE <br />PLUMBMO CONTRACTOR MAIL AODRESS CILY ZIP PHONE LICENSE• <br />I4 <br />�7./ CCl It �Ll f Mi�j� C� _�n �, � 4JT-M r: '923 - 921 ��_ <br />CLASS OF WORK <br />NEW ❑ ADDITION ❑ ❑ ❑ ❑ ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION Z <br />O <br />1 <br />VALUATION OF WORN (COST OF MATERIALS PLUS LABOR) Ir <br />L�lyix, --�tx 7nnfLsuNn 'N.)iIAPS � m <br />0 of ttT-Q Vc'Tl nm <br />USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Or <br />ANYOTHER STATEOR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />okw / - R _8 i <br />APPIICAI Tf.RYRURINrti^.IKTN,r Nn <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR A"AHAFOUR OPIES) 'ice <br />T� <br />LOT--.�BLOCK-�OFblzvl�:eo/IN <br />,� �' <br />1 <br />L9Ts. PA(- - J% RE- 12 * O <br />rnn.Irfi AI1D1�REo���IV —E4 'may <br />V <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS—H.P. EA <br />BATHTUB <br />_ <br />ellh <br />REFRIGERATION UNITS—H.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS—H.P. EA. <br />SHOWER <br />_ <br />GAS FIRED A.C. UNITS—TONNACE EA <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS—B.T.U. M EA <br />_ <br />DISHWASHER <br />B <br />_ <br />WALL HEATERS—B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />4 <br />00 <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />4 <br />CLOTHES DRYERS <br />OQ <br />URINAL <br />VENTILATION FAN <br />QQ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK SERVICE —BAR, ETC. <br />WOODSTOVE/FIREPLACE INSERT <br />_ <br />SUB TOTAL <br />0(7 <br />SUB TOTAL f <br />3 <br />PERMIT <br />PERMIT S <br />_ <br />TOTAL FEE $ <br />OD <br />TOTAL FEE <br />THIS PORTION TO BE COMPLETED <br />BY BUILDING DEPT. PERSONNEL <br />FRONT SETBACK <br />tE Z / <br />REAR SETBACK <br />/Z, <br />SIDE SETBACK <br />//� ! <br />PLAN CHE K NUMBER <br />/� <br />rVt <br />PLAN <br />FEE /�� <br />CHECK FEE <br />RECEIPT <br />N��— <br />UBE ZONE <br />LOT AREA <br />1 <br />/51735 SE <br />VACANT NO <br />�S ONO <br />NO. OF DWELLING UNITS <br />L <br />FEES <br />VALUATION <br />FEE <br />- <br />TYPEOFCONST. <br />N <br />C-LUPANCY GROUP <br />'3 <br />BUILDING <br />� <br />S � <br />BIG <br />1�)'c <br />SIZE OF SLOD G. <br />5/.r x <br />NOSTOnOr STORIES <br />'L <br />MAX. OCC. LOAD <br />2 <br />PLUMBING <br />Q <br />FIRE SPRINKLERS REQUIRED El YES "O <br />APPLICATIONACC. BY LPLANSCHECKEDSY <br />L)E <br />APPR. FOR ISSUANCE BY <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />3 <br />— <br />Q <br />- <br />1�1 M <br />N � <br />rrn <br />mo <br />--Ic <br />om <br />-4 <br />m_ <br />Q 2 <br />My M <br />� N <br />s <br />oz <br />--1 <br />S <br />mn <br />N <br />or <br />Crn <br />(A1 <br />3 N <br />ZA <br />rrn <br />70 <br />