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_� <br /> 1Ire Ll�er¢reen �O ����� ��'� �� <br /> r�1rO; � <br /> ��a'r��� P6RIylI� PERMIT N0. �!_U."i :� ;j <br /> CITY HALL 259�8745 <br /> EVERETT,WA96207 ❑ COMBINATION ❑ BUILDING ❑ MECHPNICAL �, PLUMBING <br /> OVINER MPIL AODRE55 GITY 21P PMONE <br /> Scott Thompson 1812 Lombard Everett 98201 <br /> ARC!/ITECT OR DESIGNER 1dAIL AO�RE55 QTY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL IODRESS CITV ZIP PHONE LICENSE a <br /> IdECMANICAI.CONTRACipR MAIL ADDPE55 QTY ZIP PHONE LICENSE k <br /> PLUIdBING WNTFFCTOR 1dAIL AODRESS CITV 21P PMONE LICENSE N <br /> Wilson Plumbing 3305 1G1 Avenue S.E, Everett 98205 334-6539 <br /> c�ass oF v+oaK WILSOP193PA <br /> O NEW ❑ ADDI710N O ALTERA710N C$NEPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VALUATION OF WORN <br /> 5 <br /> DESCRIBE WORK <br /> PFOPOSEO USE OF BVILDING <br /> I HEREBY CER7IFT" iHP.T I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND hNOW THE SAME TO BE TRUE AND <br /> LEG4L DESCRIPTION OF PROPC:iTY(SMOW 9ELOW OR ATTACM POUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 2 <br /> LOT__BLOCN_OF GOVERNING THIS TYPE OF \%JORK WILL BE COMPLIED WITH � <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT Pi tESUME TO GIVE AUTHORI7Y TO VIOLATE �' <br /> - OR CANCEL THE P'�OVISIONS OF ANY OTHER STATE OR r•� <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF �ONSTRUCTION. „ ,. <br /> J00 AOOFESS SIGNATURE OF CONiflA�OF Ofl PUTMORRED AGENT �ATE —I T <br /> 1812 Lombard X���n���.>�i�., .?,v ��,ti 11/8/84 �, � <br /> N 2 <br /> PLUMBING MECHA�iICAL o m <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE m o <br /> WATERCLOSET�TOILEn Z OO AIR COND. UNITS— H.P. EA. � � <br /> 1 BATHTUB 2 OO REFRIGERATION UNITS— H.P. EA. _ � z <br /> 1 LAVATORY�WASH BASIN) 2 OO 601LERS — H.P. EA. m '""� <br /> SHOV:EF GAS FIRED A.C. UNITS —70�NAGE EA ,� z <br /> KITCNEN SINK 8 DISP. 2 00 FORCED AIR SYSTEMS— B.7.U. M EA. <br /> D--I <br /> DISHWASHER WALL HEATERS— B.T.U. M r = <br /> LAUNDRYTRAY UNIT HEATERS— B.T.U. M � N <br /> -G <br /> 1 CLO7HES WASHER 2 00 EVAPORATIVE COOLERS �A <br /> WATER HEATER CLOTIIES DRVEflS T � <br /> URINAL VENTILATION FAN � m <br /> 2 <br /> DRINKING FOUNTAIN RANGE HOOD m � <br /> N <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. O r <br /> VACUUM BREAKERS STOVE — WOOD n m <br /> C (n <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE S GHIMNEY ' � <br /> m <br /> SINK(SERVICE— BAR, ETC.) FIREPLACE INSERT � r <br /> HEAT PUMP ' m <br /> n <br /> s <br /> --� <br /> x <br /> n <br /> z <br /> SUB TO7AL S 10 00 SUB TOTAL 5 ,� <br /> PERMIT 5 3 00 PEHMI7 5 � <br /> 70TAL FEE 5 13 00 TOTAL FEE 5 N <br /> SIDE YARU SETBACK STAEET SETBACK REAF VARD SETBACK PLAN CHECK NUMBER PLAN CHeCK FEE Z <br /> O <br /> FEE RECEIPT NO. -'� <br /> USE ZONE LOT AREA VFCANT SITE n <br /> 'YES �...NO FEES VALUATION FEE m <br /> TTPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING 6NITS <br /> BUILDING $ <br /> .,I.'E OF BLDG. N0.OF STORIES MAX.OCG LOAD <br /> PLUMBING 13 OO <br /> FIHG ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> YES NO <br /> APPflOVALS BY OATE �THER . <br /> 1.ENVIRONMENTAL CHECK LIST pENALTY U.B.C. <br /> SEC.303(a) <br /> 2.9UILDING PLANS <br /> 3.FIRE HVDRANT TOTAL 13 OO <br /> 4.FIRE PROTECTION SYS7EM PERMIT VALIOATION <br /> 5.GRADWG NJMEN PROPERLY VALI�ATEO QN THIS SPACE)THiS IS YOUR PERk�IT (1^,. <br /> ,.—i <br /> G.DRAINAGE � <br /> � S <br /> , 7.ENVIRONMENTALIMPACTS7ATEMENT <br /> e.HEALTH DISTRIC7 <br /> APPLICATION ACG. eY PLANS CHECKED BY APPR. FORISSUANCEBV <br /> /�.71�p',_=,` ':9�'. <br />