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the Everreen 'r:®NSTRUCTION-- --I <br />eeerett PERMIT PERMIT NO.09282 <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUN113ING <br />OWNER MAIL ADDRESS C,P ZIP PHONE <br />1Cim Sardra Gudgel 10304 33rd Ave. S.E. Everett 98204 337-1213 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP .'HONE LICENSE 0 <br />Same <br />MECHAN6AL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSED <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE♦ <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR INNEMOUTION El FENCE ❑SIGN ❑GA,,AGE <br />VALUATION OF WORK <br />E <br />Demolish Single Family Residence <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT OF CANT'gCTOflO AU�AG DATE <br />X 5/19/81 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATACH FOUR rZPIES) <br />29 Beverly Acera a <br />Lor BLOCK —OF y g <br />/,f �.� "Zf`- `% <br />JOB ADDRESS <br />7029 Lower Ridge Road <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />I RANGE HOOD <br />FLOOR DRAIN <br />I AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />_ <br />SINK (SERVICE — BAR. ETC.) <br />SUBTOTAL <br />SUB TOTAL E <br />PERMIT <br />S <br />PERMIT E <br />TOTAL FEE <br />$ <br />TOTALFEE <br />E <br />SIDE. YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />_ <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />!� <br />00 <br />00_ <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD - <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />REQUIRED <br />OYES <br />SPRINKLERS <br />ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.S.C. 1 <br />SEC. 303 (a) <br />i <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />00 <br />00 <br />4. FIRE PROTECTION SYSTEM <br />PERMWHENIT VALIDATION <br />PROPERLLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />In (I <br />III '� a O O• J 0 -- <br />N <br />i - <br />: <br />!; 1": U <br />5. GRADING � <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />APPLICATION ACC, BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />M.D. <br />ADDRESS FILE <br />