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�he firer,�reei� <br />��,�F �o �C�N�TRUCTIO� � <br />everett PERII�IT PERMIT NO. 15215 <br />CITY HALL 259�8745 <br />EVERETT, WA 98201 �] COMBINATIOF! � BUILDING X❑ MECHANICAL � PLUMBING <br />OWNER IdAILADpRESS CIiY Z�P PHONE <br />D. K. Doph Jr. 5113 23rd Avenue W��t Everett 98203 355-1850 <br />APCHITECI' OR OESIGNER dAIL AOORESS GRY Zi> FHONE <br />GENERAL WNTRACTCR MAIL ADORESS GTY ZIP PMONE UCEkSE M <br />Doph Enterprises _ <br />MECHANICALCONTRICTOR MlILF�pRESS CITY ZIP nyONE LILENSEM <br />PLUMBING GONTflACTOR MfdL ADDRESS UTY ZIP P!'pJE LIG2NSE N <br />�NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STGVFJFIREP.'_ACE INSERT <br />$'i4 , 500. 00 <br />Construct <br />LOT= 41 BLOCN_OF <br />I,ot #1 <br />�oe nooRess <br />74�8 Lower <br />PL;1MB NG <br />�gg�{}��x Two Unit Apartmen� <br />fY �SMOW BELOW OR ARACH FOUR COPIES) <br />Beverly Acr.e Tracts <br />J 12 28 9 <br />Road <br />TYPE OF FIXTU <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />DISHWASIIER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />UHINAL <br />DRINKING FOUN7AIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS - RAINLE <br />SINK (SERVICE - BAR, E <br />s� <br />IISE ZONE <br />R-2 <br />TYPE OF CONST. <br />V-N <br />SIZE OF BLDG. <br />R-3-1768 Sq. Ft. <br />OR <br />SUB TO <br />PERMI7 <br />TOTAL <br />io� <br />R-3-M <br />I None <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />_ BUILDING PLANS ^� <br />3.FIREHYDRANT � <br />4. FI(7E PROTECTIOjJ SYSTEM- <br />5.GRADING -� <br />.6.-DRAINAGE� �- �� <br />�ENVIRONMENTALIMPACTSbATEMEN <br />B'.i�EALTH OISIFICT N <br />�� _, n o <br />� o <br />" r� I <br />� <br />FEE <br />i 36 <br />S <br />S 36 <br />REAR VARD SETBA( <br />zo� <br />VACANT SITE <br />��5 C;NO <br />NO. OF DWELLING i <br />2 <br />MA%.00C.LCAGD <br />FIRE SPRINKLERS <br />FEDUIRED <br />, YES <br />BY DATE <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMI,VED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PFiOVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIcD WITH <br />WHCTHER SPECIFIED HEREIN OR NOT. THe GRAN7ING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AU i HORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATIN CONSTRUCTION OR THE <br />PERFORM E F C UC 10 . <br />SIGN E Q�jT PCfO RIZ A'NT DfTE <br />X � �� �G� �� gS <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />AIR GOND. UNITS - H.P. EA. <br />REFRIGERATION UNITS - H.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.U. N <br />UNIT HEATERS - B.7.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR MANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />ME7AL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL S <br />PERMI7 S <br />70TAL FEE S <br />� <br />VAlUA710N I FEE <br />BUILDING �o4�5Q0. 3i8 �� <br />PLUMBING 36 �� <br />MECHANICAL i4 OO <br />OTHEfl <br />PENALTY U.B.C. <br />SEC. 303 (a) <br />TOTAL 388 00 <br />PERMI7 VALIfiATION <br />yr��1� p{i(}PEaLy� VALIDAT�(IN THI�'IP� iE) THIS�I$„YAU� P�RpAIT Qp <br />U S ti �� �� S[ U T•�� <br />N <br />� <br />��. I ! i : � `� � � �T 'i �: il i ; i::: C � � �� �� �ri <br />ECKED BY APPR.FORISSUANCE BY <br />� •+': '�'OU T!i:•�i�i: `rOU <br />:iwri <br />i a s�P s 5 <br />ADDRESS FILE <br />I 0 �' ° ` <br />Si u) <br />