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- , - <br /> �,,�E"�sYOF - _ CpNSTRUCTl01�� � <br /> everett PERMIT pERMIT IvO. O695Z <br /> CITV HALL 259�8745 <br /> EV[RE1T.WA 90207 ❑ COMBINATION � BUILDING ❑ MECHANICAL PLUMBING <br /> OP�NLR MPILAODRE55 CITY 21P PhONE <br /> Steven G. Brown 2501 Euclid 98203 355-6387 <br /> ApCNITECT OR DESIGNEfl MAIL AODRE55 CITY ZIP PHONE <br /> GENERALCANTfL'1CTOR MAILAOORE55 CITY 21P PMONE UGi3N5EI <br /> Same <br /> MEGHANICRL CANiRACTOP MAII ADDPE55 Cltt ZIP PHONE LICENSE I <br /> VIUMBINGCANTRACTOR MAILAOOFE55 GITY Z�P PHONE UCENSE� <br /> CLASS OF lVOfiK <br /> ❑NEW ❑A�DITION A'Iri1LTERATION ❑REPAIR ❑DEN.OLITION ❑FENCE ❑SIGN ❑GARAGE <br /> YALUATION OF WORK <br /> f 2���0.00 <br /> OESCRIBE WORK <br /> Convert single family residence to Duplex <br /> PROPoSED USE OP BUIl01NG <br /> Duplex I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> IEG�LDESCRIPiIONOFPROPERTVI5HOW8ELOWONATTACNFOUNCAFIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or 23 a�aK 1z oF Pinehurst Div. A TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUA4E TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO• <br /> — VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE 0=CONSTRUCTION. <br /> SIGNATUFEOFCONiRAGTORORAUtHORIZEpAGENt OATE <br /> JOB POORE55 <br /> zsol Euclia X�r—i ` ` 11/1 �9 <br /> PLUMBIN6 MECHANICAL <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.R EA _ <br /> LAVATOfiY(WASM BASIN) BOILERS—N.P.EA. <br /> SHOWER GAS FIRED AA. UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—8 T.U. M EA. <br /> DISHWASHER WALL HEATERS—B.T.U. M <br /> LAUNDRY TRAY UNIT HEATEfiS—�.T.U. M _ <br /> CLOTHES WASHER EVAPORATNE COOLERS — <br /> WAf E!1 HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANG[HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— GF M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—PAINLEADERS METAL FIREPIACE 8 CNIMNEY <br /> SINK ISERVICE—BAR,ETC.) <br /> —i__---_ <br /> SUBTOTAL SUBTOTAL S <br /> PEHMIT S PENMIT S <br /> TOTALFEE S TOTAIFEE S <br /> SIDE YARD SETBACK STREET SETBACK FEAR VARD SETBACK FIAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AHEA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S 00 00 <br /> 512E OF BLDG. NO.OF STORIES MH7(.OCC.LOAD <br /> PLUMBING <br /> FIRE 20NE BASEMENT FIFE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> LIYES ❑NO <br /> APPpOVALS BY OATE �THER <br /> t. ENVIRONMENTALCHECKLIST PENALTY U.9.C. <br /> SEC.303(a) <br /> 2. BUILOING PLANS 00 00 <br /> k a, TOTAL <br /> 3. FIRE HYDRANT <br /> 4. FIRE PROTECTION SYSRM+1 PERMIT VALIDATIO'rl <br /> �.� � �__ WHEN PROPERLY VALIDATED(IN THIS SPACE)7HIS IS VOUR PERMIT <br /> � '. �� �•5. GRADING.'� Environmental @��d�E%KX Checklist not N <br /> j _6.'DFA1 e.,_ required, Bob Lnadles 11/15/79 � <br /> i .V77. ENYI M AL'MP STATEMENT Single Family residence existing and only � <br /> � B. HEAL i icr o sheetrocking needed for conversion to a 0 <br /> � �y'' APPLIQAFION f�.BY ' LANS CHECKED BY APPR.FOR ISSUANCE BY FeeliSdSBiidflfit�X COl1BCtPd OIl Permit #6926. <br /> ���'•� :` � � . . <br /> r. 11/9/79 <br />