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. , <br /> lheE��ergreen � � Cr "NSTRUCTION � � � � <br /> CITY OF <br /> everett PERMIT PERMIT NO. 07633 <br /> CITV HALL 259�8745 <br /> EVERETf.WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNEN MA�LAU�RESS CITY 21P PHONE <br /> BOSk2t Iar1'y M 891'� F}nerGnn Plare F`L�+'Ptt 9R20d �5S-11R6 <br /> ARCMITECT OR UESIGNER MAIL ADORE55 QTY Z�F PMONE <br /> G[N[RAL CANTRACTOR MAIL ADDRESS CITY ZIP PMONE LIGENSE� <br /> •.`--s-- ^--^'-�'-�'^� 1 R20 1 S6th N F Arl inv}nn QR79't F,59-7704 �7R I.�Vi <br /> MECMRNIr„p�CONTRACTOR MAILAD�PESS QTY 21P PHONE LICENSEI <br /> PlUMBINGCONTRACTOR MAILADORE55 CITY ZIP PHONE UCENSE/ - <br /> ClASS OF WORK <br /> ❑NEW �IADDITION OALTERATION ❑R[PAIR ❑DEMOLITION ❑FENCE OSIGN ❑GARAGE <br /> VALUATION OF WOflK <br /> 5 16�20�.�0 <br /> OESCRIBE WORK <br /> D2C�Y'OQfI d�1t1017 O 1 � <br /> PROPoSEU USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> LEGAL�ESGRIWIONOFPROPERiYISNOWBEIOWORARACHFOURCOPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> A�L PROVISIONS OF LAWS AND ORDINANCES GOVERNiNG THIS <br /> �oi 30 e,ocK_oF COYreCted Plat of TYPE OF WORK WILL BE COMPLIED WITH WHETHCR 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 /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JOBAOORE55 SIGNAT REOFCONiRAGTOR UTHORIj AGENi DATE <br /> i � <br /> PLUMBING MECHA CAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ], WATER CLOSET(TOILET) AIR COND.UNITS—H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA <br /> � LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SHOWER Z OO GAS FIRED AC.UNITS—TONNAGE EA. <br /> hITCHEN SINK 8 DISP. FORCED AIR SVSTEMS—�T.U. M EA. <br /> OISHWASHER WALL HEATERS—B.T.U. M <br /> UIUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATNE COOLER$ <br /> WATER HEATER CLOIHES DRYERS <br /> URINAL ]. VEN7ILATION FAN <br /> DRINKIN�FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIP HANDLING UNIT— CF.M. <br /> VACUUM BREAKERS STOVE <br /> qOOF DRAINS—RAINLEAOERS METAL FIREPLACE 8 CHIMNEV <br /> SINK(SERVICE—eAR.ETCJ <br /> SUB TOTAL SUB TOTAL S <br /> PERMIT S PEflMIT S <br /> TOTALFEE f O TOTALFEE S <br /> SIDE YAFD SETBACK STREE7 SEiBACK REAR VARD SETBACK PLAN CHECK NUMBEP PLAN CHECK FEE <br /> G F22t ZO E�2t'. ZO FeEt FEE RECEIPT NO. <br /> USEZONE LOTAREA VACANLSITE 80/7633 22.�0 48773 <br /> R-1 ❑YES �JNO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GF.OUP NO.OF DWELLING UNITS .ti <br /> SIZE OF BLOG. NO.OF STORIES MAX. .LOAD BUILDING 5 ],(7�ZOO.00 HO OO <br /> 2nd story PLUMBING 6 00 <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS 2 OO <br /> REOUIRE MECHANICAL <br /> 3 , oves rgGo <br /> APPflOVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U B.C. <br /> w SEC.3031e) <br /> 2. BUILDING PLANS <br /> . 3. FIRE HYDRANT t TOTAL $$ OO <br /> 4. FIRE PRUTECf10N SYSTEM PEHMIT VALIDATION <br /> �5. GRADING� ' W��rN�R�F�7LYVALIDl�ifyDQN�H�ssP3 0�4 4s�sYo}1F�P�R�ITO O �� � <br /> `- t iJ U U �7 o U t'i <br /> .C6. ORAINAGE � O $18.00 Due on Plan Check Fee � M <br /> �f. ENVIROIfMEOI�LIMPA�STAT[MEN( <br /> B. HEALTHDIS7RICT �" Y�;� '� � i. R�CEIPT ��p���R RcCE1PTti <br /> QN'PLICATIOt�A BY "PtANS CHECKED BY APPR.FOR ISSUANCE BY ;.�h,�'` lr�l U i I-1 AN K Y O U � <br /> �.. I <br /> C � V.1: <br /> �� <br /> ) ' <br />