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1heEvergreen ��� CONSTRUCTIOty � <br /> GTY OF <br /> everett PERMIT PERMIT N0. 09138 <br /> CITV HALL 259�B745 <br /> EVERETf,WA sa2oi ❑ GOMBINATION �BUILDIN(3 ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILADDFESS GITV 21P PHONE <br /> Charles P. Holgate 4902 Foreat Drive Everett 98203 258-3279 <br /> ARGHREQ OR DESIGNEP MRIL ADDPESS GITY 21P PHONE <br /> GENERALCONTMGTOfl MRILADDPE55 CITY ZIP PHONE LICENSEI <br /> Same <br /> MECHANICA�GONTFAGTOR MRILAOpRE55 GITY ZIP PHONE UCENSEI <br /> PLUMBINGCANTMGTOR MAILr1p�PE55 JITV 21P PMONE LICENSEI <br /> CLASS OF WORK <br /> ❑NEVJ �ADDITION ❑ALiERAT10N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> Vr1LUATION OF WONK <br /> S 7000. �� <br /> DESCPIBE WORK <br /> @ 20'x20' Addition to Exiatin Residence <br /> PROPOSED USE OF BUILDING <br /> Single Family Reaidence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEG THIS AP• <br /> LEGRL�ESGNIPiION OF iPOPEHTY(SHOW BEIOW OFlATTACM FOUPGpPIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CARRECT. <br /> 49 Forest Park Div. A ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or e�oc�_oF TYPE OF WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED <br /> liEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE O ON. � <br /> JOB ROGRESS SIG T E OF CON ACLOF 0 RUT IZE GENT ORTE <br /> 4902 Foreat Drive X �j-� �. <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � WATER CLOSET(TOIIEi') AIR COND.UNITS—H.P.EA. <br /> BATHTUB ' REFRIGERATIONUNI75—H.P.EA <br /> �AVATORY(WASH 9ASIN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE En. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHEF WALLHEATERS—B.T.U. M <br /> IAUNDFV TRAY UNIT HEATERS—B.T.U. M . <br /> CLOTHES WASHER EVAPORATIVE COOLERS � <br /> � WATER HEATER CLOTHES ORYERS <br /> � URINAI VENTILATION FAN � <br /> � DRINKING FOUNTAIN F7ANGE HOOD <br /> . FLOOR DRAIN '�IR HANDLING UNIT— C.F.M. <br /> � VACUUM BflFAKERS STOVE <br /> � ROOF ORAINS—RAINLEAOERS METAL FIREPLACE 8 CHIMNEY � <br /> SINK(SERVICE—BAR,ETC.) <br /> SUBTOTAL SUBTOTAL i ' <br /> PEXMR i PENMIT S <br /> TOTALFEE 3 70TALFEE <br /> SIDE YARD SETBACK STREET SEfBACK REAR YARD SETBACK PU1N CHECK NUMBER PLAN CHECK FEE <br /> 6� 2�� 20 ' 81/9138 FEE $�.50 RECEIPTNO. <br /> USE 20NE LOT AREA VACANT SITE S S 9 <br /> R-1 11900 SQ. F ❑YES �7�0 FEES VALUIITION FEE <br /> TYPE OF fANST. OCCUFANCY GflOUP NO.OF DWELLING UNITS <br /> V-N R-3 1 <br /> SIZE UF BLDG. N0.OF STORIES MAX.OCC.LOAD BUILDING E��OOO. S Z 6 3 <br /> ZO�XZO� j PLUM�ING <br /> FIREZONE BASEMENT FIRESPRINKLEflS <br /> REOUIREO MECHANICAL� <br /> �YES 0 <br /> APPpOV11L5 BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENHLTY U.B.C. <br /> SEC.303(a) <br /> 2. BUILOING PLANS <br /> 3. FIRE HVDRANT <br /> 707�� 5 2 6 3 <br /> d. FIRE PROTECTION SYSTEM PENMIT VAUDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS VOUR PERMIT <br /> 5. GRADING � __ � <br /> 6. DRAINAGE Original plan check Zfee o�r��• ��ar e <br /> $52.63 reflecta increase in value9 <br /> 7. ENVIRONMENTALIMPACTSTATEMENT dRd differectial betweem original � <br /> Q� <br /> 9. HEALTHDISTRICT Plan Check of $32.83� Per�lit;;feRs��T O <br /> . APPLICATIONACC.BY PLANSCHECKEDBY APPR.FOflISSUANCEBY dRd balance OW1RcJ OIl Plan •fheck. � <br /> : . � �.. J <br /> V.C. L.C. <br /> i � r:';�Y � � <br /> ADDRE55 FILE <br />