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. , <br /> lhe£verqrceii <br /> ��T�°� � CONSTRUCTIO. : <br /> everett PERN� IT PER�dIT NO. 1�9� 9 <br /> CITV HALL 259�8745 <br /> EVERE7T,WqgB201 � COMBINATION X�X] BUILDING ❑ MECHANICAL ❑ pLUMBING <br /> OWNER MAIL ADDPE55 CITY <br /> JOHN BELEIV 125 Gateiaay Everett WA 98203 ZP 355-3509� <br /> ABCHRECT OR OESIGNER MAIL ADDRESS CITY <br /> ��P PMONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY <br /> ZiP PHONE �ICENSE� <br /> Everett Bldrs 5606 Evergreen 14ay Everett 98203 353-7161 223-01- <br /> MECMANICAL GONTRACTOR MAIL ADORE55 CITY ZIP P [ - E PH <br /> � PLUMBI6G CONifiACTOR MAIL ADDRE55 CITY Z�p prypryE UCENSE• � <br /> t <br /> CLASS OF 1VORK <br /> ❑NEW ❑ AODITION � ALTERATION ❑REPAIR O DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSER7 <br /> VALI�ATION OF WORK <br /> f 14� 125. �� <br /> DESCRIBE WORN <br /> ano�o Eo SeoFB�,o,N�emodel to bathroom and kitclten; painting, no plumhing <br /> Res idence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGALDESCRIP710NOFPROPERTY�SHOWBELOWORATfACMFOURLOPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK__OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> 14estwood Plat Of Blk 000-D-00 PERMITDOESNOTPRESUMETOGIVEAUTHORITYTOVIOLATE <br /> �� OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUGTION OR THE <br /> J00 ADDRE55 PERFOFM NCE O CONSTRU1GTION. <br /> SIGNATUR CONTRq O OR AUiHO FEO GENT OATE <br /> 125 Gate�vay X ' , ,�� ' , � 5/3/83 <br /> PLUMBING MECHANICAL , <br /> N0. TYPE UF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> _ WATER CLOSET(TOILEn AIR COND.UNITS— H.P. EA. <br /> BATHTUB REFRIGtRq710N UNITS— H.P. EA. <br /> LAVATORV�WASHBASIN) BOILERS— H.P. EA. <br /> _ SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITCHEN SINK&DISP. FORCED AIR SYSTEMS— b.T.U. M EA. <br /> DISHWASIIER WALL HEA7ER5— B.7.U. M � <br /> LAUNDRY TitAY UNIT HEATERS— B.T.U. M <br /> C�OTHES WASHER EVAPORATIVE COOLERS <br /> WA7ER HEATER CLOTHES DRVERS <br /> URINAL VENTILATION FAN <br /> DRINNING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS S70VE—WOOD <br /> ROOF DP.AINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL f SUB TOTAL S <br /> Y <br /> PERMIT S PERMIT S <br /> TOTAL FEE S 70TAL FEE S <br /> SIDE YARD SE7BACK STREET SE78ACK REAR 1"ARD SETlIACK PLAN CHECK NUMOER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOi AREA VACAN7 SITE <br /> : �YES :�NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GPOUP NO.OF DWELLING UNITS <br /> SI2E O� BLDG. �10.OF STOFIES MA%.OCC. LOAD BUILDING S ],Q 1 Z S. 11 O S O <br /> PLUMBING <br /> FIHE ZONE BASEMENT FIRE SPRINKLERS <br /> � REOUIRED MECHANICAL �,; <br /> YES ':NO <br /> APPROVALS BY DATE �THER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> 2.BUILDING PLANS SEC.303�a) <br /> 3.FIRE HYDRANT TOTAL Z Z O S <br /> 4.FIRE PROTECTION SYS7EM PERMIT VAIIDATION <br /> a S.GRADING WHEN PROPERLY VALIDATED�IN THIS$P�C,E�JHIS 19fY0Ul�I�RK�1 fl �� � 1 <br /> 6.DRAINAGE 6 7 6 � 1 � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � <br /> B.HEALTHDISTRICT YOUR RECEtP� <br /> APPLICATION ACC.BY PLANS CHECKED BV APPR.FOR ISSUANCE BY <br /> TH���lK YOU <br /> stg lnc <br /> - 3 �nr 8 3 <br /> ADDRESS FILE <br />