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ie - c � 1 <br /> CITY OF <br /> everett PERI�iT PERMIT NO. 0�142 <br /> CITY HALL 259�8745 � COMBtNATIOtJ �t BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> EVERETT,WA 88207 <br /> M411.AOGRE55 <br /> CITY ZIP PMONE <br /> OYlNER <br /> Hellen Huseby 1406 Lombard Everett ZiP pHONE <br /> MAIL ADDRE55 CI7Y <br /> ARCHREGT OR DES�GNER . <br /> AfAIL AOORESS <br /> CITY ZIP PHONE LICENSE I <br /> GEHERAL GONTRACTOii 3 3 4-3 6 8 3 <br /> Snohomish County Home Improvement I�akec Stevens Z �„oNE ucense� <br /> tdELMANiCALWNiPACTOR <br /> Mni�nooaess SN OA OC H308DZ <br /> MAII A�DRES.`, <br /> CITY ZIP FNON <br /> �LUMBING CANTRAGTOP <br /> C!ASS OF W OPK <br /> ❑NEW ❑ADDITION ❑ALTERATION ��{EPAIR ❑DEMOLITION ❑PENCE ❑SIGN — GARAGE <br /> VALUAiION OF WORK <br /> s 4450. 00 <br /> DESGRIBE WORK <br /> Reside Residence-Vinyl �iding <br /> PP0�05[0 USE O�C+UILDING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ieGn�oescaianor+oFPaoPenrr�sr+ov+ee�owonnrrncHFouacoaies qLLPROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS <br /> �o, 30 B��K?a$,F 14th Street Addition TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOl� <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR PERFORM CE OF CONSTRUCTION. <br /> SIGNAiU " OR Al THORIZED .t NT <br /> JOB FDDPESS y J 4 16 a 1 <br /> 1406 Lombard ^ <br /> MECHANICAL __ <br /> PLUMBING FEE <br /> FEE NO. TYPE OF EQUIPMENT <br /> N0. TYPE OF FIXTURE OR ITEM qiR coNa UNirs—H.r. En <br /> WATER CLOSET(TOILET) REFi71GERAT10N UNITS—H.R[A <br /> gATHTUB BOILERS—H P.EF. ._ <br /> LAVATORY(VlASH BASIN) GAS FIRED AC.UNITS—TONNAGE EA. <br /> ShIOWER FORCED AIR SYSTEMS—B.T.U. Pd EA. <br /> KITCHEN SINK&DISP. WALL HEATERS—B T.LL M <br /> DISHWASHER UNILHEATERS—B.T.U. N' <br /> IAUNDRY TRAY EVAPORATIVE COOLERS <br /> CLOTNF.S Nl,15HER CLOTHES DflYE�%_ <br /> WATER HEATER VENTILATION Fr� <br /> URINAL pANGE HOOJ <br /> DRINKING FOUNTAIN qIR HANULING UNIT— QF.M. <br /> GLOOR DPAIN STOVE <br /> VACUUM BREAKERS METAL FIFEPLACE 8 CHIMNEV – <br /> ROOF DRAINS—RAINLEADERS — <br /> SINK ISERVICE—BAR,ETC.) <br /> SUeTOTAL S — <br /> SUB TO7AL pERM1T S <br /> PERMIT S TOTAL FEE E <br /> TOTAL FEE S pLAN CHECK FEE <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBEF �EE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> L'YES ❑NO <br /> TYPE OF CANS7. OCCUPANCY GROUP NO.OF DWELLING UNITS g 44 S O. 00 5 O S O <br /> �UILDING <br /> SIZE OF BLDG. NO.OF STORIES M�1%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIFE SPRINKLEflS MECHANICAL <br /> REOUIRED <br /> ❑YES f"INO <br /> pPPpOVALS <br /> BY DATE OTHER <br /> U.B.C. <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY SEG 303(a) <br /> 2. BUILDING PLANS TOTAL 5 0 S 0 - <br /> 3. �IflE HYDRANT <br /> PERMIT VALIDATION <br /> 4. FIRE PROTEC710N SYSTEM WHEN PROPERLY VALIDATED pN THIS SPACE)THIS IS YOUR PERMIT <br /> [ N�{ <br /> 5. GRADING �� � r � q �� J O. 5 O — �S <br /> G DRAINAGE T"I <br /> 7. ENVIRONMENTALIMPAC7 S7ATEMENT � <br /> B. HEALTN DISiflICi � � � ' i O <br /> qpPq.FOR ISSUANCE BY � �� � �� <br /> APPLIGATION ACC.8Y PLP.NS CHECKED BY , , , � <br /> ADDRESS FILE ' � '�' ' � � <br />