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� <br /> _ — �'! <br /> '�'�`���TYeaF r �'ONSTRUCTION <br /> everett PERMIT PERMIT NO. 120�.0 <br /> CITY HALL 259�8745 <br /> E\'ERET7,WA98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILAOORE55 GITY ZIP PMONE <br /> Ernest F. Taylor 211!. Fulton Everett 98201 359-6722 <br /> ARCMITECT OR OESIGNER MAIL AOOHESS GITY ZIP PMONE <br /> GENERAL CONTFACTOR MAIL ADDRESS GITY ZIP PHONE LICENSE� <br /> Same <br /> MECHANICAL CONTRACTOR MAIL AODRESS CITY 21P PNONE LIGENSE• <br /> PLUMBING CONTNACTOR MAIL AODPESS CItY 21P PHONE LICENSE� � <br /> � <br /> CLASS OF WOFK <br /> ❑NEW ❑ ADDITION ❑ ALTERA710N �REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALUATION OF WORK <br /> s 900.00 <br /> DESCRIBE WORK <br /> re-roof--composition <br /> PROPOSED USE OF BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> sinqle familv re ' APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL�ESCFIPTION OF PROPERTY�5110W BEIOW OR ATfACH FOUfl COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> Pt�m S_(jBLOCN 447oF Minnesota 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 CONSTRUCTIOIJ OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB AODRE55 EIGNATUPE OF CONTRACTOR OR A THOR12 qGE T OATE <br /> �� 5/19/83 <br /> 2111 Fulton X � � � <br /> PLUMBING MECHANICAL ' <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WA7ERCLOSET�TOILEn AIR COND.UNITS— H.P. EA. <br /> BATHTl1B REFRIGERATION UNI75— H.P. EA. <br /> LAVATORY(WASH BASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIPED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNORY TRAY UNIT MEATERS— B.T.U. M <br /> CIOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILA710N FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKE(75 STOVE—WOOD <br /> ROOF DRAINS— RAINLEADEFS METAL FIREPLACE S CHIAINEY <br /> SINK�SERVICE— OAR,E7C.) FIREPLACEINSERT <br /> HEAT PUMP <br /> SUB TOTAL i SUB TOTAL S <br /> y PEHMIT S PERMIT f <br /> TOTAL FEE S 707ALFEE S � <br /> SIDE YARD SETBACK STREET SE7BACK REAR YARD SETBAGK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE :OT AREA VACANT SI7E FEES VALUATION FEE <br /> :-.YES �.�NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNI7S <br /> �UILDING s900. 16 00 <br /> SIZE OF BLOG. NO.OF STORIeS MA%.OCC.LOAO <br /> PLUMBING <br /> FIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL � <br /> � REOUIREO <br /> _ "..YES . NO <br /> APPROVALS BY DA7E OTl1ER <br /> 1. ENVIRONMENTAL CHECK LIST PEN4LTY U.B.C. <br /> SEQ�03(a) <br /> 2.BUILDING PLANS TOTAL 16 00 <br /> 9.FIRE HYDRAN7 <br /> d.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> � 5.GRADING WHEN PROPERLY VALIDATED(IN Tl�SISpJ��E)iHlg I$V�yR P�F�MIT Q <br /> � � iU e uu �; <br /> 6.DRAINAGE � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � N <br /> B.HEALTHDISTRICT ' Y�.+�U R RECEIPT � <br /> APPLICATION ACC.BY PLANS CHECKEO BY APPR. FOR ISSUANCE BY . <br /> TNAtdK YOU <br /> 20 �r83 <br /> ADDnESS FILE <br /> • � <br />