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U�c Llrrxreen <br /> ���Y°F 'r �'ONSI'RUCTIOI� <br /> evere�t P�RMIT PERMIT NO. �.4776 <br /> CITY HALL 259�87C5 <br /> EVEREiT.WA 98201 � COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILAODRE55 CITY Z�o <br /> TOIII Moffatt ].,5�2 i,ombard PHONE <br /> Everett 98201 252-7745 <br /> APCHITELT Ofl DESIGNER ldqlL ADpPE55 qiY <br /> ZIP PHONE <br /> GENEFAL CONTRAGTOR MAIL AOONESS CITV ZIP PMONE �ICENSE I <br /> Everett Bldrs Inc. 5606 Evergreen Way Everett 98203 <br /> MECMANICAL CONTRACTOfl 353-7161 <br /> MAIL AODRESS CITY IIP PHONE �ICENSE Y <br /> EVEREB*301 PH <br /> PLUMBING CONTRACTOR MAIL A�OFESS CITY Zip PHONE UCENSE I <br /> CLA55 OF WORK <br /> ❑ NEW ❑ qDDITION �},{qLTERHTlO� ❑qEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ yrpOD STOVFJFIREPLACE INSERT <br /> VALUATION OF YJOFN <br /> + 6865.00 <br /> DESCFIBE WOFK <br /> Install vinyl siding, windows, insulation <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERT�FY THAT I HAVE READ AND EXAMINED THIS � <br /> LEGAL DESCPIPTION OF PROPERTY�SHOW BELOW Ofl ATTACH FOUR COPIES) APPLICATION AND KNOW THE SAME TO BE TRUE AND � <br /> Hilton 2nd CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> ��3.1-e�ocK31�oF GOVERNING THIS TY�E OF WORK WILL BE COMPLIED WITH •• <br /> 32 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 OR THE y �j <br /> J00 AD�RE55 PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONTRACTOR OR TMORIZED AGENT OATE ~ � <br /> 1502 Lombard X 4/25/85 � <br /> PLUMBING � <br /> MECHANICAL �i� <br /> h��• TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE p <br /> WATERCLOSET(TOILEn AIR COND. UNITS— H.P. EA. � <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> LAVATORV�WASMBASIN) BOILERS — H.P. EA. � Z <br /> SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. � � <br /> KITCHEN SINK&DISP. FORCED AIR SYSTEMS— B.T.U. M EA. I--I H <br /> DISHWASHER . � r� <br /> ' WALL HEATERS— B.T.U. M <br /> LAUNDRV TRAV UNIT HEATF.RS— B.T.U. M O � <br /> CLOTHES WASHER EVAPORATIVE COOLERS �N <br /> WATER HEATER CLOTHES DiiYERS y� <br /> 11RINAL VENTILATION FAN ��j N <br /> DRINKING FOUNTAIN RANGE HOfrD � <br /> FLOOR DRAIN AIR HANUI.'NG UNIT– <br /> C.F.M. N <br /> VACUUM BRENKERS STOVE– WOOD <br /> ROOF ORAINS– RAINLEA�ERS METAL FIREPLACE 8 CHIMNEV � <br /> SINK(SERVICE– BAR, ETC.) FIREPLACE INSEAT <br /> HEAT PUMP <br /> � <br /> SUB TOTAL S SUB TOTAL 5 � <br /> PERMI7 S PERMIT S N <br /> TOTAL FEE S TOTAL FEE 5 <br /> SIDE YARD SETBACK STREET SETOACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE H <br /> FEE RECEIPT NO. [n*7 <br /> USE ZONE LOT AREA VqCANT SITE <br /> !lYES : '.NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> SIZE OF BLDG. NO. OF STORIES MAX.OCC. LOAD BUILDING b 6865. 62 SO <br /> PLUMBING <br /> FIFe ZONE BASEMEIJT FIRE SPRINKLERS <br /> REOUIRED !v1EGHANICAL <br /> YES :NO <br /> APPROVALS BY DA'iE nTHER <br /> 1.ENVIRONMENTAL CHECK LIST U.B.C. <br /> 2.BUILDIYG PLANS PENALTY SEC.303(a) <br /> 3.FIREHVDRANT TOTAL EZ SO <br /> 4.FIRE PROTECTION SVSTEM PERMIT VALIUATION <br /> S.GRAOING WHEN PROPERLV VALIDATED(W THIS SPACE)THIS�IS VOUR PERMIT l�ja <br /> fi.DRAINAGE — . � _ . . -' -- .. , <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � � <br /> B.HEAL7H DISTRICT �; <br /> APPLICATION ACC. 9Y PLANS CHECKED BY qppp, FOR ISSUANCE BY � �. i �-'� <br /> P,C)Df<FSS fILF <br />