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r <br /> 1 <br /> Ihc E�•crAreen <br /> everett r %�NSTRUCTIO �� <br /> CITYHALL259�8745 PERMIT PERMIT NO. 12�42 <br /> EVERETf,'.�A96201 � COMBIP!ATION J� BUILDING ❑ MECHANICAL ❑ PLUMBING ■ <br /> OWNER h7AILa�DRE55 GITV ZIP PMONE ` <br /> FRANK MILLER 3702 FRIDAY V R TT WA 8 0 5 0�� <br /> ARGMITECTOflDESWNER MAILADORESS CITV 21P PHONE <br /> GENEPAL CONTRACTOR MAIL ADORESS CRY ZIP PHONE LICENSE� <br /> G & W ROOFING 10924 - 19th SE Everett WA 98 04 334-0535 <br /> MECMANICAL CONTflACTOR MAIL ADORE55 CITY ZIP PHONE LICENSE N ^ <br /> 1 1 <br /> PLUMBING CONTRACTOR MAIL AD�RE55 CITY ZIP PHONE LICENSE Ir <br /> CLASS OF WORN <br /> O NEW ❑ ADOIr�ON ❑ ALTERATION KXREPAIR ❑ DE.NOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLFCE INSER7 <br /> VALUATION OF WORK <br /> S 9�0.00 <br /> OESCRIB!WORN <br /> Reroof - composition <br /> PPOPOSED USE OF 6111L�ING <br /> Resi dence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGPL DESCRIPTION OF PROPERTY�SHOW BELOW OR ATTACN FOUR COPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOi_BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <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 /> LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRESS SIGNAiII E OF CONTFACTOR OR AUTNOR2ED AGENT DATE <br /> 3702 Friday Avenue X 6 2 3 <br /> PLUMBING MECHANI L <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERClOSET(TOILEn AIR COND. UNITS— H.P.EA. <br /> �A7H7U8 REFRIG�RATION UNI75— H.P. EA. <br /> LAVATORY�WASH BASIN) BOILER�— H.P. E�. <br /> SHOWER GAS FIRED A.C.UNITS —TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHVJASHER WALL HEATERS— B.T.U. M <br /> LAUNORYTRAY UNIT HEATERS— B.7.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> F�OOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKEqS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAF, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> � <br /> SUO TOTAL a SUB TOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE S <br /> SIOE YARD SE7BACK STtiEET SETBACK qEAR YARO SETBAC!( PLAN CHECK NUMBER PLAN GHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> I.:YES �..NO FEES VALUATION FEE <br /> TYPE OF C011ST. OCCUPANCY GROUP NO.OF OWELLING UNITS <br /> BUILDING s 900.00 16 00 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOAD <br /> L PLUMBING � <br /> FIRE ZONE BASEMEN7 � FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> YES NO <br /> APPROVALS BY DATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> 2.BUILDING PLANS SEC.303�al <br /> , 3.PIRE HYDRANT TOTAL �6 OO <br /> � a.FIREPROTECTIONSYS7EM PERMITVALIDR710N � <br /> 5.GRAOING WHEN PROPERLV VALIDATED QN THISS SP?��TMIS�I^yYQU[i PpRy11T (� <br /> 6.DRAINAGE � � U I 6 0 U 4 <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � <br /> B.HEALTM DISTRICT N <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR.FOR ISSUANCE BV YD U R REC E I PT `� <br /> T.HANK YOU <br /> ADDRESS FILE L o � 83 <br /> • ,� <br />