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� U�c Evergrcen �pNSTRUCTION - <br /> CITY OF <br /> everett PERMIT pERMIT NO. O911L <br /> CIN hIALL 259-8745 <br /> EVER[TT,WA 9820t ❑ COMBINATION ❑ BUILDING �X MECHANICAL PLUMBING <br /> pWNER <br /> MAIL AD7RESS CITY Z�P PHONE <br /> Joseph & Jewell I. Jordan 23627 - 150th SE Monroe WA 98272 79 - <br /> AFlCNITGGT OR D['aIGNER <br /> MAILAD�flESS GITY �IP PHONE <br /> GENERAL CONifiACTOR <br /> MAI�AO�RES$ CITY 21P PHONE LICENSE• <br /> Owner <br /> MEGHqNICAIGONTRAGTOfl <br /> MAIL AOORE55 GIiY ZIP PHONE LIGE�lSL I <br /> PLUMpING CONiNACTOR <br /> MAIL AD�RESS �ITY ZIP PNON6 LICENSE I <br /> GLASSOF WOFK <br /> �(JEW OADDITION ❑AL7ERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GAFAGE <br /> VALUA i ION OF\40RK <br /> S <br /> DESGFIBE WORK <br /> Freestanding wood stove <br /> PROPOSEO USE OF BIIILDING <br /> Residence I HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINED THIS AP� <br /> iec��oescaiarioNOFPnoPeanisHoweeiowon.>rrncMFour+coPiEs� PLICATION ANG KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GC�VERNING THIS <br /> �or ��oc�_oF TYPE OF WORK WILL DE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO- <br /> VISIONS UF ANY OTHEH STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> St ATUNEOFGONiR Ci0R0-��� IZEDAGEM� DAIE <br /> oBA9345Mukilteo Blvd, Everett 4/10 81 <br /> PLUMBING MECH ICAL <br /> N0. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF EOUIPMENT <br /> FEE <br /> WATER CLOSET(TOILET; AIR COND.UNITS—H.P.EA. <br /> REFflIGERATiON UNITS—HP.EA <br /> B�THTUB <br /> BOILERS—��.P.EA. <br /> �AVATORY(WASH BAS�N) <br /> GFS FIRED A C.UNITS—TONNAGE EA. <br /> SHOWER <br /> FORCED AIR SYSTEMS—B.1.U. __ M EA. <br /> KITCHEN SINK 8 DISP. i�� <br /> WALL HEATERS—O.T.U. _ <br /> DISHWASHER ti� <br /> UNIT H[ATERS—B T.U. <br /> LAUNDRY Tf1AY <br /> EVhPORATNECOOLERS <br /> CLOTHES WASHER CLOTHES URYERS <br /> WATER HEATER <br /> VEN'IiAiION FAN — <br /> URIN�L <br /> RANGEHOOD <br /> ORINKING FOUNTAIN C.F.M. <br /> AIR HANDLING UNIT— <br /> FLOOR ORAIN STOVc <br /> VACUUM BREAKERS ' <br /> METAL FIREPLACE&CHIMNEY <br /> ROOFUf7AIN5—RAINLEADERS 1 W d <br /> SINK�SERVICE—BAR.ETC.) <br /> SUBTOTAL = <br /> SUB TOTAL pERM1T S � .. <br /> PERMIT t <br /> 70TALFEE S TOTALFEE S _ <br /> PLAN CHECK FEE <br /> SIDE YARD SETBAGK STREET SET�ACK R[AR YARD SETBACK PLAN CHECK NUMBER FLE RE.^.EIPi No <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 $ <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAC <br /> PLUMBING <br /> FIRE ZONE B�'�<<•���� REOUIRED KI.ERS ��ECHANICAL 14 50 <br /> ❑YES L1N0 <br /> APPHOVALS <br /> BY DAT[ OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U B C <br /> SEC.303 W) <br /> 2. �UILDING PLANS TOTAL <br /> 3. FIRE HVORANT . <br /> 4. FIRE PfiOTECT10N SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(W THIS SPACE)THIS IS YOUfi PERMIT <br /> 5. GFADING n �j � <br /> 6, DFiAINAGE �' r� ��: � C. i! I �. J � �'� <br /> 7. ENVIRONMENTAL IMPACT Sit. AENT � <br /> 0. HEALTH�ISTRICT , _ Q <br /> , �f�� <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE 6Y � � . t� .� • <br /> UC � ' �'�� � '.� <br /> . . \ �':. <br /> ADDRESS FILL' �� �� � � �.� � <br />