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. . µ:`� r;iy. 'ri_S6i?+3f . .. .. . .... . <br /> f,;. ' <br /> ^,*,��;.w;, . �'s`.� .:�;�. <br /> aS . � , <br /> the E�•ergreen <br /> � CnNSTRUCTION - �'� <br /> CITY OF p ERM IT <br /> everett PERMIT NO. Og56 <br /> CITY HALL 259�8745 �MECMANICAL ❑ PLUMBING <br /> EVERETT.WA 98201 ❑ COMBINATION ❑ BUILDING zv PMONE <br /> ciTr 98203 259-2973 <br /> MAILADDRE55 Everett <br /> owr+ea 327 CroWn DYiVe p40NE <br /> Joseph R. Twardoski ci�,, z'a <br /> MAII ADDRE55 <br /> ARCNITECT OR�ESIGNEN � pMONE UGENSE I <br /> Gltt ZIP <br /> MAIL ADDRES$ <br /> GENEPP'-GONTRACTOR pHONE UCENSEI <br /> CITY Z�P <br /> MAIL ADDRESS <br /> MECHANICALGONTRACTOR pHONE LIGENSG� <br /> GITY Z�P <br /> S ame Mq��qpDRESS <br /> PLUMBING CANTPALTOF <br /> Ctn55oFwoaK ❑N� �qODITION ❑A�TERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GHRAGE _ <br /> VALUATION OF WORK <br /> S <br /> OESCA�BE WORK S t O V e <br /> install wood burning <br /> PNOPOSED USE OF BUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> LEWLDESCNIPiIONOF PROPERTYISHOW BELOW ORATTA�H FOURCAPIES) ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING TtiIS <br /> TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECI�IED <br /> �oT e�aK_oF HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUMETO GIVE AUTHORITY 70 VIOLATE OR CANCELTHE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONS7RUCTION OR THE PERFORMANCE OF CONSTR�U ETION. <br /> $IGNA E OF GONTRAGTOR OR AUiHOPIZED AGENT B/17/81 <br /> �oe nooaess X <br /> 327 Crown Drive M HANI AL <br /> FEE <br /> PLUMB�Na Np, TYPE OF E�UIPMENT <br /> NO. TYPE OF FIXTURE OR ITE!.1 FEE A�q COND.UNITS—N��.EA. <br /> WATER CLOSET QO�LEn REFRIGERf.TION UNITS—H.P.EA <br /> BATNiUB BOILERS—HP.EA. <br /> LAVATORY 1WASH 6ASIM GAS FIRED A.C.UNITS—TONNAGE EA. <br /> SHOWER FORCED AIR SYSTEMS—B,i.U. M EA. <br /> KITCHEN SINK 8 DISP. WALL NEATERS—F7 T�U. M <br /> DISHWASHER UNIT HEATERS—BT.U. <br /> LAUN�RY TRAY E�APOPA7IVE COOLEFS <br /> CLOTHES WASHER CLOTH[S DFIYERS _ _ <br /> WATER HEAt�q VEN11ll�TION FAN <br /> URINAL qANGE HOOD QF.M. <br /> DRINKING fOUNTAIN AIR NANDLING UNIT— <br /> FLOOR DRAIN STOVE <br /> VACUUM�RFAKERS METAL FIREPLACE&CHIldNEY <br /> ROOF DRAINS—AAINLEADERS <br /> SINK(SERVICE—�AR•ET�.� <br /> �„uTorn� s 4 50 <br /> PERMIT S <br /> SUBTOTAL 3 <br /> PERMI( S 70TAL FEE <br /> TOTAL FEE S PLAN CHECK FEE <br /> pEAR YARD SETBACK PLAN CNECK NUMBER RECEIPT N" <br /> SIDE YAPD SETBACK <br /> $7qEEi SETBACK FEE <br /> � VALUATION FEE <br /> ��T ARE� VACANT SITE FEES <br /> USE ZONE OVES ❑NO <br /> OCCUPANCY GROUP NO.OF DWELLING UNITS 5 <br /> TYPE OF CANST. BUILDING <br /> NO.OF STOHIES MA%.��LOAD pLUMBING <br /> SIZE OF BLDG. 1¢ S O <br /> BASEMENT FIRE SPRINKLERS MECHANICAL <br /> FIRE ZONE REOUIRED <br /> ❑YES ❑NO <br /> DATE OTHER <br /> qppROVALS BY U B C. <br /> PENAL'�' SEC.303(a) <br /> 1. ENVIRONMENTAL GHECK LIST <br /> 2. BUILDING PLAN3 T�TA� <br /> 3. FIRE HY�RANT pERMIT VAL��AT�ON <br /> 4. FIRE PPOTECTION SYSTEM WHEN PriOPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMI O <br /> � ' C ,. � � �, � ^ —cd� <br /> 5. GRADING Lf7 <br /> ' 6. DRAINAGE � <br /> 7. ENVIRONMENTAL IMPAGT STATEMENT - � i, � ��� <br /> �; �+[A�iH DISLPIf,T __ _ . � <br /> �,,;1 16 <br />