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-I <br /> dir Ecrrcrceri � ���ST R U CT I Q �! <br /> Glv Ci � <br /> everett PERIVIiT PERMIT N0. 1 � Jl � <br /> CITY MALL 259�8745 <br /> �— EVERETT.WA98207 ❑ COMBINATION �I BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> p\YNER MAILAO�RESS CITY ZIP PHONE <br /> OSIE SWARTZ 4021 FRIDAY EVERETT WA 98201 �TY 252-4497ZP PHONE <br /> ARGMITECT OR DESIGNER MAIL ADDRESS <br /> GENERALGONTRACTOR MAILA�DRESS CITV 21P PMONE LICENSE� <br /> EVERETT BUILDERS 5606 EVERGREEN WAY EVERETT WA �8203 353-7161 EVERE8301PH <br /> MEGHANICALCONTRACTOR MAILAO�RESS CIiV 21P FHONE IICENSE <br /> PLUM9ING LONTRAGTOfi MAIL AOOHESS CITY 21P PHONE LICENSE� <br /> GLASS OF W ORK <br /> ❑ NEW ❑ ADDITION ❑ ALTEFATION O�REPAIR ❑ DEMOLITION ❑ FENCE O SIGN O WOOD STOVIJFIREPLACE INSERT <br /> VqLUAT10N OF WORK <br /> =284�.�� <br /> OESCRIBE WORN <br /> RerooF and gutters <br /> PROPOSEO USEOF BUIL�ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Residence qpPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALOESCRIPTIONOFPROPERTY�SHOWBELOWOFATfACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES z <br /> � GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH -�i <br /> LOT__BL1CN�oF H ad� WHETHER SPECIFIED HEREIN OR NO"f.THE GRANTING OF A '" <br /> LOtS 7 - 10 PERMITDOESNOTPRESUMETOGIVEaUTHORITYTOVIOLATE �,�,^ <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE � � <br /> 4680-001-007-000 PERFORMANCE OF CONSTRUCTION. <br /> JOB AOORESS SIGNqTURF.�9F CONTRA O OR AUTHONI2E0 AGEjJ,r . �ATE �..� ._.� <br /> 4021 rriday X �'�i;� c� �`c�—/1��2�85_ or=" <br /> PLUMBING MECHANICAL ^��. Y m� <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EUUIPMEN7 FEE o 3 <br /> WATERCl.OSET�TOILET) AIR COND.UNITS — H.P. EA_ m <br /> BATH7UB �REFRIGERA710N UNITS- Ii.P.EA. _ "'� <br /> m <br /> LAVATORY(WASH OASIN) 601LER5- H.P. E4 Q = <br /> SHOWEti GAS FIRED A.C. UNITS-70NNAGE EA. C <br /> D -I <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS- B.T.U. M EA. r' _ <br /> DISHWASHER WALL HEA?ERS- B.T.U. M '"'� N <br /> < <br /> LAUNDRY TRAY UNIT HEATERS- B.T.U. N1 '� <br /> O v <br /> CLOTHES WASHER EVAPORA7IVE COOLERS _ '� �' <br /> WATER HEATER CLO7HE5 DRYEFlS __ '� m <br /> S <br /> URINAL VENTILA�ION FAN _ rn � <br /> N <br /> DRINKING FOUNTAIN RANGE HOGD � <br /> o r <br /> FLOOFi DRAIN �IR MANOLING UNI7- C.F.M. _ _ n m � <br /> C V� <br /> VACUUM BREAKERS S70VE-WOOD _ 3 � <br /> m <br /> ROOF DRAINS- RkiNLEADERS METAL FIREPLACE&CHIMNEY = n <br /> -i r <br /> FIREPLACEINSERT ' '� <br /> SINK�SERVICE- BAR,ETC.) A <br /> - HEAT PUlAP <br /> --I <br /> 2 <br /> — a <br /> — z <br /> � <br /> SUB TOTAL f SUB TOTAL S � <br /> PERMIT f PERMI7 S N <br /> TOTAL FEE S TOTAL FEE t � <br /> SIDF YARD SE7NACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE -� <br /> FEE RECEIP7 NO. C� <br /> m <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> . YES .�.NO _ <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS _ <br /> BUILDING S 2847.00 38 50 <br /> SIZE OF BLDG. N0.OF STORIES MA%.OCC. LOAD <br /> PLUMBING <br /> FIPEZONE BASEMENT REOUSRED KLERS MECHANICAL _ <br /> YES . NO <br /> APPHOVALS BY OATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B G <br /> SEf,.903�a1 <br /> 2.BUILDING PLANS TO7AL 3H SO <br /> 3.FIRE HVDRANT <br /> 4.FIRE PROTEGTION SVSTEAI PENMIT VAI.IDATIJ�� <br /> WHEN PIIOPEFLV VALIDATED(IN THISj�A�EA THIS I�`(��R�E�M�{T _ � <br /> S.GRAOING % II � �� <br /> 6.DRAINAGE <br /> 7.ENVIRONMENTALIMPAGTSTATEMENT • � � <br /> B.HEALTH DISTFICT � � � ,,�. �_ ���' ' <br /> ,i '�. .l i . � , i <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY , <br /> , , , i _. J <br /> eb <br /> - �� ��r � '� <br /> nneF�ess ri�e <br />