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dic E��er¢reen <br /> everet� � �ONSTRUCYIO� � <br /> PERMIT PERMIT NO. �-3�-�� <br /> GITV HALL 259�B7d5 <br /> EVERETT.WA98201 [] COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER M41LAD�REES CiTY ZIP YMONE <br /> I]011f,l AS Pf1RTFR 7 MAf NQLTII FVERETT WA -- <br /> ' ARLHITECTORDESIGNEF MAILADDRESS CITY ZIP PHONE <br /> GENERAL CONTYAGTDR MAIL POORE55 GITY ZIP PHONE LILENSE M <br /> MECHANILAL C��IACTOR MAII AD�R SS CITY 21P ONE� LICENSE M <br /> P�UMCING GONTRACTOR MAII AD�FESS GITY ZIP PHONE IILENSE� <br /> CLASS OF 1YOflK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION �REPAIR � DEMOLITION � FENCE ❑ SIGN ❑ WOO�STOVEIFIREPLACE INSLRT <br /> VALUATION OF WORN � <br /> f 47�.00 <br /> DESCRIBE YIORK <br /> Replacing front half of existin roof <br /> PROPOSED USE OF dUILDING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAPAINEU THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALOESCR�FTIONOFPFOPERTY�SHOWBE.OYIORATTACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT__OLOCK__OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHE.THER SPECIFIED HEREIN OR NOT.THE GRANTItJG OF A <br /> P�RMIT�lOES NOT PRESUMETO GIVE F,UTHORITY TO VIOLATE <br /> OR CANCtL THE PROVISIQNS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULAT�NG CONSTSUCTION OR THE <br /> PERFORMANCE OF CONSTRUC710N. <br /> J09<.ppRE55 SIGNA E OF CON/�ACTOR OR AUTHORRED AGENT DATE <br /> 7 Ma nolia ��1��1 3/13/84 <br /> PLUMBING MECHANI�L <br /> NO. TYFE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) AIR COND.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P. EA. <br /> LAVATORY�WASH BASIN) BOILGRS— H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINN 8�ISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWl.SHER YlALL HEATERS— B.T.U. M <br /> LAUNDRYTPHY UNIT HEATERS— B.T.U. M <br /> CLOTHES VJASHEF7 EVAPORATIb'E COOLERS <br /> WATER HEATER CLOTHES ORYFRS <br /> URINAL VENTILATION FAN <br /> ORINKING FOUNT.IIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING 11N1T— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMYEY <br /> SINN(SERVICE— BAR, ETC.) FIREP�ACE INSERi _ <br /> HEAT PUMP <br /> SUB TOTAL S SUBTOTAL S <br /> PERMI7 S PERMIT 5 <br /> TOTAL FEE S TOTAL FEE S <br /> SIDEYARO SETBACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT 40. <br /> USE ZONE 1.0T AREA VACANT SITE <br /> !1YE5 :;NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING 11NITS <br /> BUILDING $ 470. 10 00 <br /> SIZE OF BLDG. N0.OF STORIES h1A%,OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> YES iiNO <br /> APPROVALS BV DATG OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTV U.d.C. <br /> SCQ 993(al <br /> 2.BUILDING PLANS _ TOTAL �O OO <br /> 3.FIRE HYDPANT <br /> 4.FIRE PROT_CTION SYSTEM PEflMiT VALIDATION <br /> — WHEN ?ROPERLY VAUDATED QN THIS OPO O'THIS�SOVqUf�P�R��IT � , <br /> S.GRA�ING �� I U <br /> 6.11RAINAGE � <br /> 7.ENVIRONMF.NTAL IMPACT STATEMEtJT m <br /> 8.HEAL7'H DISTRICT • /� (� <br /> AFPLICATION ACC.8Y PLANS CNECKED BY APPR.FOR ISSUANCE BY . % . '\'�-�% ��. (1 I <br /> . � . , i:. ..'1 � �� <br /> . i '_ <br /> � i ;..� <br /> � � i �y <br /> ADDRF.SS FILi: <br /> I <br /> i <br /> �- - <br />