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� <br /> ri:e£�rr,�reen ,ONSTRUCTIO � - <br /> Giv OF I � R,. <br /> evert�� pE�� ST PERMIT NO. 14� 52 <br /> GITY HALL 259�8745 <br /> EVERETT,WA98201 � COMBINATION � BUILDING GC MECHANICAL � PLUMBING <br /> 01YNER MAIL q00PE55 CITY ZIP PHONE <br /> Lawrence H, Nalbach 2132 Highland Avenue Everer.t 98201 252-7450 <br /> � APGNITECT OR DESIGNER MAIL ADDRE55 GITY 21P PMONE <br /> CENERAICONTRACTOR MAILAODRESi GITY 21P PMONE IIGENSEN <br /> Nalbach Construction <br /> MECHANICAL CONTRACTOR MAIL AODRESS CITY ZIP PMONE LILENSE Y <br /> ' ALUMBING GONTRAGTOR MAII ADDRESS CITY IIP PHON[ LICENSE N <br /> w� <br /> CIASS OF WORK � <br /> ❑ NEW ❑ AD�ITION O AL7ERATION YgREPAIR O OEMOLITION � FENCE ❑ SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VALUATION OF WORN <br /> 3 I.D�D��e��J <br /> DESCNIBE WORN <br /> repair foundation, and existing bathroom <br /> PROPOSED USE OF BUILDING <br /> single family residence i HER'cBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGnL0E5CRIPT10NOFPROPERTV�SNOWBELOWORATTACHFOUPGOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 6-7 638 Swallwell�s 2nd GOVERNING THIS TYPF OF WORK WILL BE COMPLIED WITH <br /> LOT_BLOCN_OF <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRE55 SIGNqTUR OF�ONTRACTO O UiMOR�ZED AGENT �ATE <br /> 3010 Everett Avenue X 11 13 84 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FUCTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET�TOI�En Z OO AIR COtJD.UNITS— H.P. EA. <br /> BATMTUB 2 OO REFRIGERATION UNITS — N.P.EA. <br /> LAVATORY(WASH BASINI 2 00 BOILERS — H.P. EA. <br /> SHOWER GAS FIRED A.0 UNIiS —TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIFi SVSTEMS— B.T.U. M EA. <br /> DISHWASHER VJAIL HEATERS— B.T.U. M <br /> LAUN�RY TRAV UNIT HEATERS— B.T.U. M <br /> 1 CLO?HES WASHER 2 QQ EVAPORATIVE COOLERS <br /> 1 WATER HEATER Z OO 1 CLOTHES DRYEFS <br /> URINAL �. VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BR�AKERS j �TOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEV <br /> SINK(SERVICE— BAR, EiC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB 70TAL + 10 00 SUB TOTAL S 15 00 <br /> PERMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE 5 15 00 <br /> SIDE VARD SETBACK STREETSETBACK REAq YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE FIECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> �,-.VES . .NO PEES VALUATION FEE <br /> TYPE OF CONST. OC:.UPANCY GROUP NO.OF OWELLING UNITS <br /> SIZEOFBLDG. NO.OFSiORIES MA%.00C. LOAD BUILDING $ 10�000. 80 SO <br /> PLUMBING 10 00 <br /> FIREZONE BASEMENT FIRE SPRINK�ERS MECHANICAL <br /> RE�UIRED 15 00 <br /> YES ;NO <br /> . APPROVALS BY DAiE O7HER � <br /> 1.ENVIRONMENTAL CHECK LIST PENALTV U.B.C. <br /> SEC.303(a) <br /> 2.Bl11LDING PLANS <br /> 3.FIREHYDRANT TOTAL ZOS O <br /> 4.FIRE PROTECTION SYSTEM� PERMIT VALIDATION ` �� � � � S� r � '� — � <br /> S.GRAOING WHEN PROPERLY VALIDATED pN THIS SPACE)THIS IS YOUR�PENMIT �v <br /> 6.DRAINAGE � � <br /> I 7.ENVIRONMENTALIMPACTSTATEMENT � �� � � - � ' � � ' � , <br /> i: I � <br /> .e,HEAL7H DISTRICT � <br /> ,APPLICATION ACC.�Y PLANS CHECKED BY APPR. FOR ISSUANCE BY . � . , , ') <br /> -� � � �ri <br /> ' <br /> �� <br /> ADDP.ESS f'ILf <br />