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a (heEvergreen r7NSTRUCTIOtd � � <br /> CITY OF <br /> everett PERMIT PERMI� NO. O91�J2 <br /> GTY HALL 259�8745 <br /> EVERETf.WA 98201 ❑ COMBINATION �BUILDING ❑ MECHANICAL PLUMB:NG <br /> Ml'.4��RE55 CITY ZIP PNONE <br /> OWNER <br /> Georgia Heathershaw 6908 Columbia Court Everett 98203 353-4 <br /> ARCHRCCT OR DESIGNER <br /> I.IAIL AOORE55 GITY ZIP PMONE <br /> GENERhLfANTPAGTOR <br /> MAILADDRE55 CITY 21P PHONE UCENSEI <br /> Same <br /> NEClIANILAL CANTRACiOR <br /> MAIL AODRE55 C!TY 21P PHONE UGENSE� <br /> PWMBING CANTPACTpR <br /> MAIL AO�RE55 GTV 21P PMONE LICENSE e <br /> C1A550F WOR✓. <br /> ONEW ❑ADDITION ❑ALTERATION j�EPAIR ❑DGMOLITION ❑FENCE ❑SIGN GARAGE <br /> VALURTION OF W OflK <br /> 55��. 00 <br /> DESCRIBE WORK <br /> roof and eaves repair <br /> PROPOSED USE OF BURDING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH - <br /> tEcniocscRivTior+oFPaorearr�sHowee�owoannncriwuacoviesi 'LICATION AND KNOW THE SAME TO BE TRUE AND CORiiECT. <br /> Snoview Ridge ALL PROVISIONS OF LAWS AND ORDINA�ICES GOVERNING THIS <br /> ior Z e�ocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPEGFIED <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 OF LOCAL LAW REGUU+TING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> S:uNATUPi CF GONiRACTOR OR NUTMOP12E0 AGENT OPTF <br /> �oenooaess . � � � � 4/20/81 <br /> 6908 Columbia Ccurt <br /> PLUMBING t�lE ANICA <br /> FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. A'R cONo.U Y 5E OH.p�AIPMENT — <br /> WATEf7 CLOSET(TOILEI l <br /> REFRIGERATION UNITS—H.P.EA <br /> BATHTUB BOILERS—H.F.EA. <br /> LAVATORY�'JASH BASINI <br /> GAS FIPED A.C.UNITS—TONNAGE EA. <br /> SHOWER <br /> FORCED AIR SYSTEMS—B T.U. M EA. _ <br /> KITCHEN SINY,8 DISP. <br /> WALL HEATERS—B.T.U. M <br /> DISHWASHEP y, <br /> UNIT HEATERS—�.T.U. <br /> LAUNORYTRAY <br /> EVAPORATIVE COOLERS <br /> CLOTHES WASHER CLOTHES DRYERS <br /> WATER HEATER <br /> VENTILATION FAN <br /> URINAL R�NGE HOOD <br /> DRINKING POUNTAIN C.F.M. <br /> AIR HANDLING UNIT— <br /> _ FLOOR DRAW STOVE <br /> VACUUM�REAKERS <br /> METAL FIREPLACE 8 CHIMNEY <br /> ROOF DRAINS—RAINLEADERS ` <br /> SINK ISERVICE—BAR.E1C.1 _ <br /> SUBTOTAL 5 <br /> SU8 TOTAL pENM1T 5 <br /> PERMIT S <br /> TO7ALFEE f TOTALFEE s <br /> pLAN CHECK FEE � <br /> SIDE YARD SETBACN SiFEEi SETBACK REAR VARD SETBACK PLAN CHEGK NUMBER FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALIIATION FEE <br /> L1YES ❑NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLItJG UNITS — <br /> BUIIDING s 500. 00 10 00 <br /> FIZE OF BLDG. NO.OF STORIES MA%.OCC.�OAD pLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIHED <br /> fiYES ❑NO <br /> APPROVALS <br /> BY DATE OTHER <br /> 1. ENVIRONMENTALCHECKLIST PENPLTY U.BC. <br /> SEC.3031a) <br /> 2. BUILDINGPLA45 TOTA� 10 00 <br /> 3. FIHE HYDRANT <br /> PEHMIT VALIDATION <br /> 4. FIHE PROTECTION SYSTEM WHEN P(iOPERLY VALIDATED(IN THIS SPACE)TNI515 YOUR PERMIT <br /> 5. GRAOING <br /> t �� 36 � � 10. 00 -�N <br /> G. DRAINAGE � <br /> 7. ENVIRONMENTAL IMPACT STATEMENT 7 � <br /> � �. : ., � �1" I Q <br /> B. MEALTH DISTRICT <br /> APPLICATION ACC.BY PLANS CHECKED 6Y APPR.FOR ISSUANCE BY ' � <br /> � � id"il U I <br /> ADDRESS FILE <br />