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�heErcrgreen {--ONSTRUCTION � <br /> qTY OF � <br /> everett PERMiT PERMIT NO. 09416 <br /> CITV HALL 259�8745 <br /> EVEFiETf,WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> �W��P MHILAOpq[55 GItY p�p FM04F <br /> William W. Haker 5005 Glenwood Everett 98203 259-3535 <br /> FRCHIiECi OR D[S�GNER MAIL AD�RE55 �ITY ZIP %10NE <br /> G[NERNLCONTRACTOR MnILPOD'tL$5 �11Y plP PHONE UCENSE/ <br /> Cosmic Construction 1320 151st Avanui� S.E. Snohomish 98290 <br /> M[CIIANIC4LGONiRACTOP � MAILAD�RE55 CIiV 71P PNONE LICENSE� <br /> CO SM IC *243K8 <br /> PIUMBING CANiRACTOR MRIL ADDRE55 CITY ZIP PNONE IICENS[I <br /> C1A550F WppK <br /> ❑NEW ❑ADDITION CK.�[TERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VRIUATION OF WORK <br /> S 3���00.�� <br /> �ESCRIBE WOPN <br /> Remodel of basement area <br /> rnoroseo use or euuowc <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAti11NED THIS AP� <br /> �ecnioescRmnor+oraaoPEarva�aweeiowonnnnaiFouacociEsi PLICATION AND KNOW THE SAME TO BE TRUE AN� CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior eu�c�_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> SW�i of SW� of Sec. 36, Twn. 29N, Rn HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> 9' PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPRO� <br /> 9 EWM VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JO�ADDRE55 SIGNAiU NTMCTO A 12E0 aGENT DAiE <br /> 5005 Glenwood Avenue X � <br /> PLUMBINO MEC AL , ' <br /> NO. TYPE UF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> 1 WATER CLOSET(TOILET) AIR COND.UNITS— HP.EA. <br /> �ATHTUB REFRIGERATION UNITS—H.R EA <br /> �. LAVATORV(WASM BASIN) 801LEflS—HP.EA. <br /> �. SIIOWER Q GAS FlHED AG.UNIIS—TONNAG[EA. <br /> KITCHEN SINK 8 DI50. FORCED AIR SVSi[IAS—B T.U. M EA. <br /> DISHWASHER WALLHEATEPS—�T.U. M <br /> IAUNDRV TRAV UNIT HEATERS—13.T.U. M <br /> 1 CLOTHES WASHER Z p� EVAPORATN[COOLERS <br /> 1 WATER HEAiER 1 CIOTH@5 DRYERS <br /> URINAL ], VENTILATION FAN <br /> DPINKING FOUNTAIN RANGE HOOD <br /> 1 FLOOR DPAIN AIR HANOLING UNIT— GF.M. <br /> VACUUM BREAKERS STOVE <br /> ROOP DRAINS—RPMLEADENS METAL PIREPLACE 8 CHIMNEY <br /> SINK�SERVICE—BAR,ETCJ <br /> SUB TOTAL ],2 SUB TOTAL f <br /> PEflMIT S PEPMIT f <br /> TOTAL FEE f TOTAL FEE S 'I S O <br /> SIDE YARD SETBACK STREET SEIBACK REAP YARD SETBACK PLAN CHECK NUMDER PLAN CHECK PEE <br /> 6� Z� � 20 � 81/9416 FEE125.q$ RECEIPTNO. <br /> USE ZONE LOT AREA VACANT SITE <br /> R_I ❑YES IlNO FEES VALUATION FEE <br /> 7CX <br /> TVPE OF CANST. OCCUPANCY GROUP N0.OF OWELLING UNITS <br /> V—N R-3 I <br /> SIZE OP BLDG. NO.OF STORIES MA1(.OCC.LOAD BUILDING S 3O�O00. IB 3 OO <br /> PIUhiBING 12 �0 <br /> FIRE ZONE BASEMENT FIFE SPRINKLERS <br /> Ye5 REOUIRED MECHANICAL <br /> IIVES O � SO <br /> APPNOVALS BY OATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST <br /> PENALTY UDC. <br /> 2. BUILDING PLANS �� SEC.303�e) <br /> 3. FIRE HYDRANT ' TOTA� Z 12 S O <br /> d, pIRE PROTECTION SVSTEM PEHMIT VALIOATION <br /> 6. GRAUING �' ' p <br /> _ � WNEN P(7�pERLY�VALIDATE�N TMIS SPACE)THIS IS YOUR PERAIIT <br /> 'T DRAINAGE � � � �� � � � I 1 �, � C --� <br /> �L ENVIRONMENTALIMPACTSTATEMENT � <br /> B, HEAITH DISTRICT ' � ,� � O7 <br /> '� � 0 <br /> "71PPLICF.TION ACC.BV .PWNS CHECKEO BY APPR.FOR ISiUANCE BV ' ' " ' ' <br /> _ I v.c. L.c. : " U <br /> !� - j ��.'_ � � <br /> ADDRESS FILE ' I ,'�-= i, I <br />