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'r ..., <br /> !he !'��ergreen � ^p�ST R U CTI O N - <br /> CITY OF <br /> ever�ett PERMIT pERMIT NO. 112H6 <br /> GN FIAL_259�8745 <br /> EVERETL`NA 98201 � COMBINATION � BUILDING C� MECf1ANICAL �I pLUMBING <br /> OWNER MAILFUpR655 CIiY IIP P��ONE <br /> Charle.s Stearns 2909 Forest View Drive Everett 98203 355-9868 <br /> ARCHITECT OR OESIGNER MAIL ADDRE55 CIiY ZIP pMONE <br /> GENERALCONT(IAGiOR MAILPppRE55 CITY ZiP CHONE LICENSEI <br /> Everett Builders Inc. 5606 Evergreen Way Everett 98203 353-7161 <br /> M1IEGHANIGlCON1RACTOR MAILADDPE55 CRY ZIP PHONE IICEN5E1 � <br /> ( EV ER EB 301PH <br /> PLUMBINGCONIRACTOR l.IAILAD�RE55 CIfY ZIP PMONE LICENSEI <br /> CLASSOF WOPK <br /> ❑NEW QI36DITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WONN <br /> E �218.�� <br /> DESCRIBE WORK <br /> 19 ' 0" x 22 ' Addition to existin <br /> PROPOSED USE OF DUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �EGA�OESCRIPTIONOFPROPERiY�5N01V8ELOWORATTACH(OURGOPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or 107B1OC1L_OF Valle Vi TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN 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 R THE PER��FQRMANCE r° CONSTRUCTION. <br /> JO�ApDRE55 SIGNAiURE �i i0R-0RAU�HOPycDAGENi DnTE <br /> 2909 Forest View Drive ,� ��p_�+ - <br /> � <br /> PLUMBING MEC �1fICh6- <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ]. WATER CLOSEi ROILET) AIR COND.UNITS—H P.EA. <br /> 1 BATHTUB REFRIGERATION UNITS—H.P.EA <br /> .1 LAVATORY(WASH BASIN) BOILERS—HP.EA. <br /> SHOWER GAS FIR[D A.G UNITS—TONNAGE EA. <br /> KIICHEN SINK 8 DISP. FORCED AIR SVSTEMS—B.7.U. M EA. <br /> DISHWASHEF \YALL HEATEPS—BSL. M <br /> LAUNDRVTRAV UNITHEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATEH HEATER CLOTHES DRYERS <br /> URINAL I. VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> fLOOR DRAIN AIR MANDLING UNIL— GP.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADEFS METAL FIqEPLACE 8 CHIAINEY <br /> SINK(SERVICE—BAR,E7C) <br /> SUB TOTAL SUB TOTAL f 3 00 <br /> � PERMIT S PERMIT f <br /> TOTAL FEE f G 00 TOTAL FEE f 3 00 <br /> SIDE'fARD SETBACK STREET SETBACK REAR YAHD SETBACK PLAN CHECK NUMBER PLAN CNECK FEE <br /> f1� ZQ � ZQ� 82/11286 FEE 44 . r,3 RECEIPiNO. <br /> USE ZONE LOT AREA VACANi SITE 6 O 81 Z <br /> R.1 ❑YES 17(yQ FEES VALUATION FEE <br /> TYPE OF CONSi. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> V-N Addition R-3 1 BUILDING g 68 50 <br /> SIZE OF BIDG. N0.OF STOPIES MA%.OCC.LOAD <br /> PLUMBING 6 00 <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS �� <br /> � REOUIR�p MECHANICAL 3 00 <br /> C1YES Vf� <br /> APPNOVALS BY DATE O7HER <br /> 1. ENVIRONMENTALCHECKLIST PENALTV U.BC. <br /> 2. BUILDING PlANS � SEC.3031a) <br /> 3. FIRE HYDRANT OO TOTAL 7 7 S O <br /> 4. FIRE PROT ION SYS7EM P T �Q�}�0 N <br /> � 1 5. GRADtNG H"��EHIYJ:AtI�TTE�THIS SPACE)TH1515 YOUR PERMIT <br /> � '�6. DW111�RE m 0 5 8�5 S 0 6 8.5 0 —�•� <br /> , 7. ENVI M AL IMVA�STA7EMENT U R REC C�PT N <br /> � B. �1EAL7HDIST�ICT • �� � ; -;an.p��,� YOU . � :YOUR REC�1P?� <br /> NAPPLICAN9N .BY LANS CHECKED�'! APPR.FOR ISSUANCE BY , T 1 . .A��..•_:y�,. - '� <br /> CFg HWM LC � ����� YY'' <br /> � . <br /> - � o�c82 : . :' . , . <br /> � " - � �c81 . <br /> ADDRESS FILE <br /> . � <br />