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�, <br /> the£•rergreen � <br /> CITYOF 1''�NSTRUCTION -� � - �. <br /> everett PERMIT pERMIT N0. OH7H6 <br /> CITY 1iALL 259�8745 <br /> EVERETT,N!A 98201 ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ pLUMBING <br /> OWNER MIIILAOOF[SS QiY ZIP PHONE <br /> James Bustad 4511 Crescent Drive, Everett 98203 252-3000 <br /> RRCHITECTORDESIGNER MAILADORE55 CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAiI ADDRE55 CITV 21P ' FMONE LICENSE I <br /> Owner <br /> MECHA'IICAI GONiRFCTOR MAIL ADDRESS CITY ZIP PMONE �ICENS[1 <br /> PIUMBINGCONTRACTOR MAILADDRESS CITY ZIP PMONE �ICENSEI <br /> CLA55OF WORK <br /> ❑NEW ❑ADDITION ❑AL7ERATION X�]REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAIUAT10N OF WOPK <br /> S �.80�.�� <br /> DESCRIBF WORK <br /> New roof <br /> FFOPOSED USE OF 9UIL�ING <br /> Residence - single family I HEREBY CERTIFY 1 HAT I HAVE READ ANO EXAMINED THIS AP• <br /> LEGALDESCRIPTIONOFPROPEPiY�5M014BELOWORATTqCMFOURLOPIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ior�_e�ce�4_oc ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH�S <br /> TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <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 OR LOCAL LAW REGULATING <br /> CONS�RUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> ' JOB FODR[55 SIGNlf�U E OF�ONiRACTOR OP AUiHORtZED AGE�T DAiE <br /> 4511 Crescent Drive, Everett ' <br /> x ��:�.����. F' ._ j'�.�s;l:�_���� i/i9�si <br /> PLUMBING A! ANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE O. TYPE OF E�UIPMENT FEE <br /> \VATER CLOSET(TOILLT) AIR COND.UNITS—H.P.EA. <br /> 9ATHTUB REFRIGERATION UNITS—HP. EA <br /> LAVATORV�flASH BASIN) �OILERS—H.P.EA. <br /> SHOWER GAS FlRED AA. UNITS— <br /> TONNAGEEA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SVSTEMS—B.i.U. 61 EA. <br /> DISHWASHER WALL HEATERS—B T.U. M <br /> '� LAUNDRV TRAY UNIT HEATERS—B.T.0 �1 <br /> CLOTHES 1YASHER EVAPpRATIVE COOLERS <br /> WATEF NEATER CLOTHES DRVERS <br /> URINAL VENTILA710N FAN <br /> ORINKING FOUNTAIN RANGE HOOD <br /> •�� FLOOR DRAM AIR HANDLING UNIT— C.F.M. <br /> IJ VACWM BREAKERS STOVE <br /> � ROOF ORAMS—RAMLEADERS METAL FIREPLACE&CHI6INEY <br /> �I��i SINK�SERVICE—�AR,[TCJ <br /> SUBTOTAL SUBTOTAL S <br /> PERMIT S PERMIT S <br /> ��� 70TAL FEE S 70TAL FEE S <br /> GI�E YARD SETBACK STREET SETBAG< REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> I:SE ZONE LOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> , TYPE OF CONST. OCCUPANCY G(iOUP N0.OF DWELLMG UNITS <br /> BUILDING E 1800.00 Z9 p <br /> SIZE OF BLDG. N0.OF SiORIES MW(.00C.LOqD <br /> PLUMBINCa <br /> FlRE ZONE BASEMENT FIRE SPPINKlERS <br /> ' REOUIRED MECHANICAL <br /> ❑YES ❑NO <br /> APPHOVALS BY DATE OTHER <br /> 1. ENVIRONMENTALCHECKLIST <br /> PENALTY U.B C. <br /> 2 BUILDING PLANS SEC.303(a) <br /> 3. FIRE HVDRANT TOTAL 29 � <br /> a. FIpE PROTECTION SYSTEM PEHMIT VALIDATION <br /> 1YHEN PROPERIY VALIDATED pN THIS SPACEI THIS IS YOUR PERhIiT <br /> 5 GRADING <br /> G DRAINAGE � <br /> 7. ENVIRONMENTALIMPACiSTATEMENT � <br /> 9 HEALTH DISTRICT � <br /> A^PIICAT10N ACC.BY PLANS CHF.CKED BY APPR.FOR ISSUANCE BY i ' <� O C f; � 0 � � d � <br /> _ .__ _ —_ . . _ _. <br /> � .. <br />