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, , <br /> rhe Evergreen � c �N ST R U CTI O N � �� <br /> pTY OF <br /> everett PERMIT FERMIT NO. O7ZO5 <br /> CITY HALL 259�8745 <br /> EVERETT,WA 98201 ❑ COMBINATION C-Ix tBUILDIN(i ❑ MECHANICAL ❑ PLUMBING <br /> JWNER MRIL A�DRF55 QTY ZIP PMONE <br /> Gary S./Kimberly A. Corbrly 6601 Glenwood Ave. 98203 355-3695 <br /> AflCHITECi OR OESIGNER MAIL AODPE55 qTV ZIP PMONE <br /> GENE9AL CONIpAGTOP MaIL A��PE55 CITV ZIP PMONE LICENS[I <br /> Same <br /> MECHANICAL CANTRACTOR MAIL ADDRE55 CITY ZIP PHONE UCENSE I <br /> PLUMO'NGCONiRnC*OR MAILAOORE55 CIiY ZIP PNONE UCENSEI <br /> CIASS OF WORK <br /> C�NEW ❑ADDITION �LiERAT10N ❑REPAIR ❑�EMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORk <br /> s 300.00 <br /> DESCRIBE WORK <br /> remodal basement area <br /> PROPOSED USE OF BUILDING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> IFGOI�ESCRIVTION OF PRpPERTY�SNOW BEIOW OR ATiACM FOUR CAPIE5) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior e�a�oF TYPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED <br /> Sec. 1 TWp 28 Rge 4 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 LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. . <br /> - JOB ADDRE55 SiGNaTl1RE OF CONiR4Gi0R OR AO7MOP12ED AGENT �FTE <br /> 6601 Glenwood, Avenue X �. � � 2 5 80 <br /> PLUMBINO MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(IOILEf) AIR COND UNITS—H.P.EA <br /> BATHTUB REFRIG[RATION UNITS—H.P.EA <br /> LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SHOWEF GAS FIREU AC.UNITS—IONNAGE EA. <br /> KITCHEN SINK 8�ISP. FO(iCLD AIR SY51'EMS—A.T.U. M EA <br /> DIRHWASHER WALL HEATERS—B.T.U. M <br /> � IAUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTIlAT10N FAN <br /> DRiNKING FOUNTAIN RANGE HOOD - <br /> FLOOR DRAIN AIR HANOLING UNIT— QF.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RA�NLEADERS METAL PIREPLACE 8 CHIMNEV <br /> SWK�SERVICE—BAR.ETGI <br /> SUBTOTAL SUB TOTAI S <br /> PENMIT f PERMIT S <br /> TOTAL FFE S TOTALFEE f <br /> SIDE YARD SETBACK STREETSETBACK REAR YARD SE7BACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE lOT AREA VACANT SITE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS . <br /> BUILDING s300.00 5 00 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIREZONE BASEMENT fIRE.?PRINNLERS <br /> FicOUIPED MEGHANICAL <br /> ❑VES ❑NO <br /> APVROVALS BY DATE OTHER � <br /> t. ENVIRONMENTALCHECKLIST PENALN U.B.0 <br /> 2. BUILDING PLANS SEC.303(a) <br /> 3. FIRE HYDRANT TOTAL S 00 <br /> 4. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING 19 5 3 S 9 4 5.O O �y�� <br /> fi. ONAINAGE Q � <br /> 7. ENVIRONMENiAL IMPACT STATEMENT 'y(��J ' <br /> e. HEALTHDISTRICT � �OU R R�CEI�1_ <br /> APPLICATION ACC.BY PLANS CHECKED GV APPR.FOR ISSUANCE 8'! r N���. Y Q�o <br /> � . . <br />