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� <br /> �� <br /> rhe Erergreen C� v ST�R U CTI O N � <br /> GTY OF <br /> everett PERMIT pERMIT N0. O f'963 <br /> CITY HALL 259�8745 <br /> EVERETT.WA 98201 ❑ !'GMBINATION ❑ BUILDING ❑ MECHANICAL XC�tPLUMBING <br /> OWNER MAILqDDRE55 CRY ZIP PNONt <br /> t83iT Everett Avenue LTD Partnership <br /> _Lf/fl <br /> ARGIUTECT OR UCSIGNER MAIL AD�RE55 CITY ZIP PHONE <br /> G6NERAL CONTRAGTOP MPIL ADDRE55 qTY ZIP PNO\E LIG[NSE� <br /> Simmonds Disign Blders <br /> MECNnNIGALCONiRAqOR MAILADORE55 CITV ZIP PHONE UCENSEI <br /> PLUMOINGCONiRAGTOF MAILADDPESS GTV ZIP PMONE LICENS[I <br /> Urban Mechanical Inc. 7309 184th Street N.W. Stanwood 652-7162 <br /> CIA55 CF WORN <br /> ❑NEW OADDITION ❑ALTERATION �REPAIR ❑DEMOLITION ❑FENCE 7SIGN ❑GARPdE <br /> VALUATION OF WORK <br /> E <br /> UESCflIBE WORK <br /> PROPOSE�USE OF BUILDING <br /> , I HEREBY CERTIFY THAT I HAVE READ ^'JD EXAMINED THIS AP <br /> LEGALOESCRIPiIONOFPHOPERTY�SMOW9GlOWORATfAGMFOUPCAPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVFFNING THIS <br /> �or o�a�_oF TYPE OF WORK WILL BF COMPLIED WITH WHETHER SPECIPIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PFESUME TO GIVE AUTHORITY TO VIOLATF OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL lAW FEGULATING <br /> - CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JOB AD�RESS '�G� ��E Of CON1P/+CiOR OR AUiHORIZE�AGENi DATE <br /> 1918 Everett Avenue �� , 7/18/80 <br /> PLUMBING E HANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEF <br /> rj WATER CLOSET(iOILEn AIR COND.UNITS—H.P.EA. <br /> BA7HTUd AEFFI�iERAT10N UNITS—H.B EA <br /> LAVATORV(WASH BASIN) ZO OO BOILLRS—N.P.EA. <br /> 1 SHOWER 2 GAS FIRED AC. UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISH\VASHEF WALL HEATERS—8 T.U. M <br /> LAUNDRV TFAV UNIT HEAI[RS—B T.U. M <br /> CLOTHES WASHER EVAi'ORATNE COOLERS <br /> �. WATER HEATER Z OO CLOTHES DRYERS <br /> UFINAL VENTILATION PAN <br /> ORINKING FOUNTAIN RANGE HOOD <br /> FLOOf�DRAIN AIR HANDLING UNIi— CF.h1. <br /> VACUUM OREAKERS STOVE <br /> ROOF DRL'!!S—RAMLEADf:iS METAL FIREPLACE&CHIMNEY <br /> �.�. SINK ISEFVICE—BAR,ETC.) _ <br /> SUBTOTAL SUBTOTAL S _ <br /> PERMIT S 3 00 PERMIT f <br /> 70TAL FEE S 9 00 TOTAL FEE S <br /> SID[VARD SETBACK STPEL7 SET�ACK REAR YARD SETOACK PLAN CHECK NUMOER PLAN CHECK FEE <br /> FEE H[CEIPi N0. <br /> USE 20NE l0T AREA VACANT SITE <br /> ❑YES GNO FEES VALUATION FEE <br /> TYP[OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING 5 <br /> SIZE OF BLOG. N0.OF STORIES MA%.OCC.LOAD _ <br /> PLUMBIN 49 00 <br /> FIRE ZONE BASEAIhNT FIRE SPRINKLEFS <br /> REOUIRED MECHANICAI <br /> I'�ES I�1N0 _ _ ' <br /> APPROVALS BV DATE OTNER <br /> t. ENVIRONMENTAL CHECK LIST PENALTY U BC. <br /> -� - SEC.303(a) <br /> 2. BUILDING PL.NS <br /> 3. FIRE HYORANT TOTAL 49 00 <br /> A. FIRE PROTECTION SYSTEM PEHMIi VALIDATION <br /> WHEN PROPEPLV VALIDATED pN THIS SPAGE)THIS IS�Y.OUR PERIdIT <br /> 5. GRADING 4 9 9 i `T, 0 :� 9. O O -- �.h <br /> 5. DRAINAGE � <br /> 7. LNVINONMENTAUMPACT STATEMENi � <br /> !3. HEALiH D�STRICT �� �' � I ;1 ?" " " � <br /> i . (��.:1� '_�i�T O <br /> APPLICATIOM1 ACC.BY PLAN$CHECKED 6Y AFPR.FOR ISSUANI,C BV <br /> � �\ �� <br /> i � . .,� : � ����� <br />