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rheE�rrgreen , �;ONSTRUCTION <br /> CITY OF p ERM IT <br /> everett PERMIT N0. 1.0004 <br /> CITY HALL 259�B7d5 � COMBINATION � BI;ILDING ❑ MECHANICAL ❑ PLUMBING <br /> EVERETT.WA 98201 <br /> MA�L AUONfl55 <br /> GIiY ZIP P110NE <br /> OIYNFR - <br /> Bert Larsson 5807 Highway Place Everect 982C3Zv 353-89�N3 <br /> MAII ADDPE55 <br /> ARCHIiEGT OR OESIGNER - <br /> `�n, Z�p PHONE UCENSE 1 <br /> GGNERAL GONTRAC70P <br /> MAIL ADDRESS <br /> Same ��T� Z�p PMONE UCENSE� <br /> MECHANIGALfANiRACTOR <br /> MAIL POORE55 <br /> � MAIL AODRESS <br /> CITY ZIP P!10NE LICENSE� <br /> PLVMBING CONTRAGTOR <br /> GV.sSOFwoPK n�N �ADDITION ❑A�TERATION ❑PEPAIR ❑DEMOUTION ❑FENCE ❑SIGN ❑GARAGE <br /> `R <br /> VAWATION OF WORN <br /> f 58����.�� <br /> OESG��OE N'ORN <br /> Construct single family residence <br /> PPOPCSEO USE OF BUIIDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> single family residence pLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> IEGAL OESG�IPiION OF PROPEPTV ISHOW OEIOW Oi ATTAGN FOU�LOPI&5) ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> Ptn 2-1 14 Victory Heights TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECii IED <br /> �oT BLOG�--OF HEREIN OR NOT. THt GRANTING OF A PERMIT DOES NOT <br /> PAESUME TO GIVE AUTHORITY TO VIOV+TE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHE TATE OR LOCAL LAW REGULATING <br /> G 31 39 5 C!Q.�STRUCTIO OR T P RFORMANCE OF CONSTR�UCTION. <br /> �IGNAT}lEOFCONi Gi0 110R�ZED/GENT <br /> \ <br /> JOD ADOR[55 X <br /> 4207 Crescent Drive <br /> MEC ANICAL <br /> PLUMBING TYPE OF EOUIPMENT FEE <br /> TYPE OF FIXTURE OR ITEM FEE N0. <br /> NO. 4 OO AIRCOND.UNITS—HP.EA <br /> Z WATER CLOSET(TOILET) 2 Q pEFRIGERAT�ON UNITS—H.P.EA - <br /> 1 BATMTUB BOILERS—H.P.EA. <br /> z LAVATORY IWASH BASIN) GAS fIPED AC.UNITS—TONNAGE EA. <br /> SHOWER 1 FORCED AIR SYSTEMS—B.T.U. M EA. <br /> 1 KITCHEN SINK 8 DISP. Wq���{EqTERS—B T.U. M <br /> 1 DISH\NASHER UNIT NEATERS—B�T-�� M <br /> �UNDRY TFiAV EVAPORATIVE COOLEi1S 5 <br /> 1 CLOTHES WASHER � 1 CLOTHF.S DRVERS <br /> 1 WqTER HFATER yENTILAT10N FAN <br /> URINAL 1 qANGE HOOD <br /> DRINKING FOUNTAIN q��HANDLING UNIT— C.F.M <br /> FLOOR DRAIN STOVE <br /> VACUUM BREAKERS METAL FIREPLACE 6 CHIMNEY <br /> ROOF DRAiNS—RAINIEADERS <br /> SINK 15ERVICE—BAR.ETC.) <br /> SUBTOTAI S S <br /> SUB TOTAL pEpM�T 3 <br /> PERMIT = TOTAL FEE S <br /> TOTAL FEE S 2 O O 0 p�pN CHECK FEE <br /> SIDE YARD SETBACh STREET SETBACK REAR YARD SETB/1CK P�AN CHECK NUMBER RECEIPT N0. <br /> �� 20' 20' 81/1004 FEE 199 . 5 55 <br /> LOT ARFA VACANT SITE FEES VALUATION FEE <br /> USE ZONE CiYES L1N0 <br /> R-1 <br /> TYPE OF OCCUPANCV GROUP NO.OF DWELUNG UNITS <br /> V-N R-3 1 6UILDING $58 ,000. 307 00 <br /> SIZE OF BLDG. NO.OF STORIES MAX.�'��A�� Z O O O <br /> PLUMBING <br /> Z�I � XSO� 1 PIRESFRINKLER$ ],S OO <br /> F!REZONE BASEMENT REOUIR[D. MECHANICAL <br /> none �IYESX1tJ0 <br /> BY pATE OTHER <br /> APPPOVALS U B C. <br /> 1. ENVIRONMENTAL CHECK LIST PENA�T� SEC 303(o) <br /> 342 00 <br /> 2. BUILDING PLANS TOTAL <br /> 3. FIRE HYDRANT pEPMIT VALIUATION � � "�� � ,� <br /> a. FIRE PROTECTION SYSTEM W HEN P00PERLV VALIDATED!IN THIS SPACE)THI595 YOUR PERMIT , � <br /> 5. GRADING � O <br /> G. DRAINAGE . . C' <br /> 7. ENVIRONMENTAL IMPACT STATE�+IENT , . , � , � . � <br /> � .,- .. c-'� <br /> 8. H�ALTH DISiRICT � � .� . '� <br /> APPLICATION ACC.B'� � PLANS CHECKED BY APPR.FOR ISSUANCE BY . . <br /> EB HWM L�' . • ', , <br /> , � <br /> � ADDRESS FILE <br /> � <br />