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� <br /> (I7CE�GTYPOP �ONSTRUCTION -�, <br /> everett PERN�IT ptRMIT NO. 11ZH7 <br /> CIT1'HALL 259�8745 <br /> EVERETT,WA sezoi ❑ COMBINATION X❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNIq MAILPDOFESS GITY ZIP PMONE <br /> Mildred Heckt 4913 Glenwood Avenue Evexett 98203 252-8130 <br /> � ARCMIiECT OR DESIGNER MAI�ADDRC55 CITY ZIP PMONE <br /> GENEF4L CANTRAC70R MAIL AD�RE55 CILY ZIP PHONE LICENSE/ <br /> Same <br /> MECHiNIGALCONTRACTOR MAILPO�RE55 CITY 21P PNONE IICENSE• <br /> PLUM3INGCONTflACTON MAILADDRESS CIiV 21P PHONE LICENSE� <br /> � � <br /> � ClASS OF WORK <br /> � ❑NEW ❑ADDITION ❑ALTERATION (f�iEPAIR �DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> f Li���.00 <br /> DFSCRIBE WORK '- <br /> Re-roof Composition <br /> PROPOSED USE Of BUILUING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- o <br /> IEGALDESCPIPT10NOFPqpPERTY�SMOWBELOWORARACMFOURCAPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. '� <br /> �--� <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS n <br /> �oT e�oc�oF TYPE OF WORK WILL BE COI'PLIED WITH WHETHER SPECIFIED m <br /> 36-29-4 HFREIN 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 LAW REGULATING -� Ti <br /> CONSTRUCTJON OR THE PERFORMANCE OF CONSTRUCTION. ,. .� <br /> JOBADDRESS SIGNAiUREO CfJNiMCtORORA iHORI .\GENi OAiE � _ <br /> m <br /> 4913 Glenwood Avenue X � 7/25/84 m o <br /> PLUMBIN(3 MECHANICAL � � <br /> NO. TYPE OF FIXTURE OR ITEM FEF NO. TYPE OF EOUIPMENT FEE �_ <br /> WATEF CLOSET(TUILET� AIR COND.UNITS—MP EA. 2� <br /> BATHTUB REFI7IGERATION UNITS—H.P.EA m <br /> LAVATORY(WASH BASIN) �ORERS—H.P.EA. C = <br /> SHON'ER GAS FIRED A.C.UNITS—TONNAGE EA. r = <br /> KITCHEN SINK 8 DISP. FORCED�IR SYSTEMS—B.T.U. M EA. "' �"' <br /> —1 N <br /> DISHWdSHER WALLNEATERS—BT.U. M K � <br /> inJNDRY TRAY UNIT HEATENS—B T U. M O .� <br /> CLOTHES WASHER [VAPORATWLCOOLERS T� <br /> WATER H[ATER CIOTHES DRVERS = m <br /> URINAI. VENTII.l�110N FAN m�" <br /> N <br /> DRIIJKING FOUNTAIN RANGE HOOD O r <br /> PLOOR DRAIN AIR HANDIING UNIT— QF.M. n m <br /> VACUUM BREAKERS STOVE ; tN/1 <br /> ROOF DRAINS—RAINLEADERS METAL FIflEPLACG 8 CHIMNEY m <br /> --I 1"�" <br /> SINK�SERVICE—BAR.ETC.) m <br /> a <br /> . A <br /> � <br /> 2 <br /> a <br /> z <br /> SUBTOTAL SUBTOTAL f � <br /> PERMIT f PERMIT f �._. <br /> TOTALFEE f TOTALFEE S N <br /> SIDE Y4RD SEiBACK STREETSETBACK REAR VARD SETBACK PLAN CHECK NUMBER PIAN CHECKFEE _ <br /> O <br /> f[E RECEIPT NO. � <br /> USE ZONE LOT AREA VACANT SITE m <br /> UYES ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OP OWEILING UNITS <br /> BUILDING E 1,000. 17 SO <br /> SIZE OF BLDG, NO.OF STOPoES MNc.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BFSEMENT FIRE SPIiINKLERS <br /> REOUIR@D MECHANICAL <br /> ❑VES I iN0 <br /> APPpOVALS BV DATE OTNER <br /> 1. ENVIRONMENTALGHECKLIST PENALTY UBC. � <br /> 2. BUILDING PLANS SEC.303(a) <br /> 3. FIRE NYDRANT TOTAL 1'7 SO <br /> 4. FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> 5. GRADING WHEN PROPERLV VALIDATED(W TI i15 15P/�Cy jH15 IS`�O�{R('C�M�T O __ � <br /> J / U � UI <br /> 6. ORAINAGE <br /> � <br /> � 7. ENVIRONMENTALIMPACTSTATEMENT (�J <br /> B. HEALTH DISTRICT i. I. . � I I�T [—I <br /> APPLICATION ACC.BV PLANS CHECNED DY APPR.FOR ISSUANCE BV � ' ' U � <br /> o �,� <br /> � . _ c i <br /> i1DDRESS FILE <br /> L -� <br />