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the Evergree <br />CONSTRUCT1OP' <br />everett <br />PERMIT <br />PERMIT NO. <br />15689 <br />CITY HALL 25M745 <br />EVERETT, WA 98201 ❑ <br />' <br />COMBINATION � BUILDING ❑ MECHANICAL `1 <br />PLUMBING <br />MAIL ADDRESS CITY <br />uP <br />PHONE <br />OWNER <br />RAY IRVING <br />6023 DEXTER EVERETT WA 9820L1 353-6849 <br />ZIP <br />PHONE <br />'-0N <br />ARCHITECT OR OESER <br />MAIL ADDRESS Y <br />LITY <br />ZIP <br />PHONE LICENSE N <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />T' <br />EVERETT BUILDERS <br />5606 EVERGREEN WAY EVERETT WA 98203 <br />2P353-716T <br />EIoNEEREB3 <br />NSEN <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />Zlp <br />PHONE LICENSE N <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />[)NEW Cl ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S 2003.00 <br />Deck and new window <br />Rea <br />LEGAL DESCRIPTION OF PROPERTY IS OW BELOW OR ATTACH FOUR COPIES) C <br />G <br />LOT 7 BLOCK_OF Fai rvi a <br />P <br />L <br />P <br />S <br />JOB ADDRESS 6023 DEXTER <br />M <br />PLUMBING <br />_ <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE N 1 <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />$ <br />PERMIT <br />$ <br />TOTAL FEE <br />S <br />SIDE YARD SETBACK STREET SETBACK <br />REAR YARD SETBACK F <br />X®YX 5 ft 20 f� <br />20 f <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES NO <br />R-2 <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />V-N <br />N <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />deck 160sf <br />FIRE SPRINKLERS <br />REQUIRED <br />FIRE ZONE BASEMENT <br />❑YES .,NO <br />APPROVALS <br />BY DATE <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />eb stg/jef <br />1C <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />ORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />OVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />ERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />OCAL LAW REGULATING CONSTRUCTION OR THE <br />ERFO MANCE OF CONSTRUCTION. <br />IG TU OFCONTRAv ORDR AUTHORIZED GENT 11/20/85 DATE <br />x 1 1 n <br />ECHANICAL <br />AIR COND. UNITS — H.P. EA. — <br />REFRIGERATION U14ITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />'LAN CHLUK N <br />85/15689 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FEE 25.03 <br />VALUATION <br />S <br />FEE <br />821/l IPT NO, <br />FEE <br />MEW <br />38 150 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS � GCEO QU) THIS�Sa P ROMIT CT? <br />LO <br />Y.-)UR RECEIPT'"' <br />-i'll' NK YOU <br />1 "TI <br />N x <br />m <br />co <br />mo <br />om <br />m_ <br />A Z <br />n -+ <br />r_x <br />- Vt <br />orl <br />n <br />3 <br />-H m <br />x <br />mN <br />v <br />om <br />C N <br />m N <br />z Cl <br />m <br />D <br />A <br />j 1 1mv 8 5 <br />ADDRESS FILE <br />