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�, <br /> ,,"``'�gY`oF r�JNSTRUCTION <br /> everett PERMIT PERMIT N0. O$$19 <br /> CITY HALI 259�8745 <br /> LVERETT,bYA 99201 ❑ COMBINATION Iy��. BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OIYNEF <br /> MAIIA��BE55 CIiV Z�p <br /> Mrs. Tegard 6706 Commercial ���ON` <br /> nncHireeroeoesicNee Everett 98201 <br /> MAIL ADDRE55 G7Y Z�p <br /> PNONE <br /> GENERAL CONiRACTOq AIAI�qppqESS <br /> Star Home Impovement 5314 2nd SL•reet c�Tr z'r PHONE LICENSEI <br /> nieci�nrv�ca�coNraacroa - uneaooaess Everett 98203 353-927g <br /> ��n Z�P PHONE <br /> LICENSE r <br /> PLUTA�INGCANiRACfON MAIIAGJFESS DI ED RW K312DC <br /> CITV z�p <br /> PNONE LICENSE I <br /> CIASS OF WORK <br /> ❑NEW ❑ADDITIOIJ ❑qLTERAT10N [RR[PAIR ❑DEh10LITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAWATION Oi WURK <br /> S 1r500. 00 <br /> DESCRIBE WORH <br /> re-roof com osition <br /> PROPOSED USE OF BUII�ING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> IEGAL DESCRIPiIOq OF PqOPERTY�SNOW BELOW OR ATTACH FOUR GOPiE51 PUCATION AND KNOW THE SAME TO RE TRUE AND CORRECT. <br /> ior 21 o�a,�4 0� Pinehurst ALL PROVISIONS OF LAWS AND ORDINNNCES GOVER�JING THIS <br /> TYPE OF WORK VALL BE COAIPUED WITH WHETHER SPECIFIED <br /> HEREIN OR �.'OT. THE GRANTING OF A PERMIT GOES NOi <br /> PRESUME TO GIVE P.UTHORIT'!TO VIOLATE OR CANCEL THE PRG <br /> VISIONS OF ANY UTHER STATE OR LOCAL LAW !�EGULA71Nc; <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> J0�ADOPESS SiGNiTURE 0'CO'�iRFCiOR OF nUiHORi2ED hGENI <br /> 6706 Commercial { °'�` <br /> i <br /> PLUMBING X �'�'fc�''" ��L _: (..�.1. ��Z q/A 1 <br /> MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> WA7ER CLOSET(TOILETI FEE <br /> AIR COND UNITS—H fl EA -- <br /> BATHTUB REFRIGERATION UNITS—H P CA — <br /> LAVATORY�WASH BASIN) <br /> SHOWER <br /> BOILERS—HP.F.A. <br /> GAS F'RED A.C.UN11S—TONNAGE EA. <br /> KI7CHEN SINK 8 DISP. <br /> FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISMVIASHER WALL HEA7ERS—B T.U. �,� <br /> LAUNDRY TRAY UNIT H[q7ERS—B.T.U. M - <br /> CLOTHES WASHER <br /> — EVAPORAtIVE COOLERS <br /> WATER HEATER CLOTHES DRVERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANOLING UNIT— <br /> VACUU�d BREAHERS Cf.M. <br /> STOVE <br /> FOOF ORAINS—RAINLE4DER5 METAL FIREPLACE 8 CHIMNEV <br /> SINK�SERVICE—BAR.ETCJ <br /> SUBTOTAL SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE S TOTALFEE S <br /> SI�E VARD SETBACK STREET SETBACK RFAR YARD SETBACK PLAN CHECK NUMOER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TVPE OP CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> SIZE OF BLDG. N0.OF STORIES MAl(.00C.LOAD BUILDING S ],S OO. O 2 S O O <br /> PLUMBING <br /> FIHE ZONE 9ASEMENT FIRE SPRINKlERS <br /> REOUIRED MECHANICAL <br /> ❑YES i�NO <br /> APPHOVALS BY DATE �Tr1ER <br /> �. ENVIRONMENTALCHECKUST <br /> PENALTY U B C. <br /> 2. OULDING PLANS SEC.303(a) <br /> 3 FIRE NYDRAHt TOTAL <br /> 25 00 <br /> <. FIRE PFOTECTION SYSTEM PERMIT VALIDATION <br /> 5. GRADING PJMEH PROPERIY VA�IDATED IIN THIS SPACE)THIS IS VOUR PERMIT <br /> 6 DRAINAGE ; � � 9 � 0 2 5. 0 0 — dn <br /> 7 ENVIRONMEN7AL IMPACT STATEA1ENi � <br /> ° HEALTH UISiFLT OO <br /> — . . .. ,�._ . � . <br /> APPLICATION ACG BY PLANS CHECKED BV APPR FOR ISSUANC[ �v ` '� ���� ' I i'T � <br /> ; U <br />