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, <br /> �heEvergreen • CO�TRUCTION � <br /> GTY OF <br /> everett ERMIT PERMIT NO. 06771 <br /> CITY HAIL 259�87d5 <br /> EVEFETf,WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING � <br /> OWNIF MNILPDURF'i5 Clh' ZIV PHONE <br /> Silver Homes Corp. 221 South Broadway 98209 353-5080 <br /> hRCHI1ECT OP OESIGNER MAIL A�OR"c55 CIiY ZIP PNONE <br /> GENERAL CONTRACiOR I,IAIL AOORE55 GITY 21P PNONE LIGENSE� <br /> Same <br /> M[CIIANICALCONfRACiOP MAILADDRESS CITY ZIP PHONE LICENS[� <br /> PLUMBINGfANiRACTOR MAILAD�RE55 GIiY ZIP PHONE LILENSEE I <br /> GLA55 OF N�ORK <br /> ❑NEW ❑ADDITION ❑ALTERA710N OR[PAIR C}p�JQEMOUTION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WOPN <br /> E <br /> DESCRIBE WOPK <br /> Demolish single family residence <br /> PROPOSED USE OF BUILOIM1.; <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> iecn�oescaiPnoNOFaRoaearvisrwwee�owor+n.raeHFoueeoPiest � PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 50 Maple Heights ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or o�oc�oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAVJ REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> J00 ADDRESS 9G R6 OF CONiFAGiOR OR rWiMORIZED AGENT [Jal[ <br /> 4627 Glenwood Ave. X � �'L <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE Op ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSEi QOILET) AIR COND.UNITS—HP. EA. <br /> �ATHTUB REFRIGERATION UNIiS—NP.EA <br /> LAVATORV(WASH BASIN� BOILERS—H.R EA. <br /> SHOW[R GAS FIRED AC.UNITS—TONNAGE EA. <br /> KI7CHEN SINK 8 DISP. FORCE�AIR SVSTEMS—B T.U. M EA. <br /> DISHIVASHER WALLHEAiERS—B.T.U. M <br /> LAUNDRV TRAV UNIT HEATERS—B.T.LL M <br /> CLOTHES WASHEt7 EVAFORATIVE COOLERS <br /> WATER HEATER CLOTHES ORYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANOLING UNIT— QF.M. <br /> VACUUM BFEAKERS STOVE <br /> ROOF DRAINS—RAINLEAOEFS METAL FIREFLACE 8 CHIh1NEV <br /> SINK 1SERVICE—BAR.ETC.1 <br /> SUB TOTAL SUBTOTAL S <br /> PEfiMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> 40E YARD SE7BACK STREET SE7�ACK REAR VARD SE78ACK PLAN CHECK NUMBEF PLAN CHECK FEE <br /> FFE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> tiYES ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNI75 <br /> BUILDING S 00 00 <br /> S12E OF BLDG. N0.OF STORIES h1A%.OCC.LOA� <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL <br /> ❑VES IlNO <br /> APPHOVALS BY DATE OTHER <br /> t. ENVIRONMEN7ALCHECKLIST pENALTV U.B.C. <br /> :. BUILDINGPLANS SEC.303(a) <br /> 3. FIFE HYDRANT TOTAL 00 00 <br /> a. FIRE PROTECTION SYSTEM PERMIT VAIIDATION <br /> \YHEN PROPERLY VALIDATED(IN THIS SPl�E1,T�1�IS YO��{EMYT'A a y�� t � <br /> 5. GRA�ING ( 7 U U V U <br /> — �"'� <br /> 6 DRAINAGE . . . ' � <br /> 7. ENVIRONMENTALIMPACT&TATEMENT <br /> 0. HEALTH DISTFICT YO U R REC E I P� <br /> APPLICATION ACG�Y PLANS CHECKED BY APPR FOR ISSUANCE BY 7'HqNK YO l! � <br /> - � UCT � 9 <br /> ADDRESS FILE <br />