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` . <br />! <br /> �heEvergreen " - ��;pNSTRlJCTi���� . <br /> CITY OF <br /> �v�l'�� PER�III� PERMIT N0. O'11H <br /> CIT1';iALL 259�9745 <br /> eveaEr.w� sszo� ❑ COMSINATIQN � BUtLDING ❑ MECHANICAL PLUMBING <br /> �' MPILPD�flESS GTY ZIP 'MONE <br /> OYINER <br /> Jonathan Bolduan 9305 0lympic Drive Edmonds 9802^ 776-76 <br /> AFGHRECT OR D[SIGNER <br /> bIqILA�DPE55 LItY 21P PHONE <br /> GENERALCANTRRCTOR <br /> MAIL ADDFE55 CItY 'IP PHONE LICE�SE I <br /> ftiverside Roof Company 2916 State Stree:: Everett 98201 258-9646 <br /> MhILnDDPES$ Gltt ZIP PHONE LILENSE� <br /> MEGHANIGF�CANTRACTOR j� �JF; jjjj $i3OZTO <br /> PLUb�01NG LOMNF.CiOR <br /> MAILApORESS LItY ZiP PNONE LIC@NSE� <br /> ClA55OP WORK <br /> ❑NEW ❑FD�ITION ❑ALTERATION XXIREPAIR ❑OE�IOLITION ❑hENCE ❑SIGN ❑GAFiAGE <br /> VqLURT10N CF V/OPK <br /> S 1,648.00 <br /> DESLR�BE WORK <br /> Snstall hot bui.lt up roof---reroof <br /> ?PGPOSE�USE OF pU1LDING <br /> Single Far.�ily Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS - <br /> LEGALCESCPIPTICNOFPROPEPtY15N0�YBELOWOFATiACHFOURCOPIE51 PLICATION AND KNOW THE SAME TO BE TRUE AND COPRECT. <br /> PTN 1-2 245 Everett Div. R ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior e�ocic.__oF _—. TYP6 OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GR�.NTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TYF PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNAIUREOFCONLFACTOFOFAUTMORIZE��GENT OAiE <br /> J09ADDRE55 X Check #3489 1/10/d0 <br /> 1303 Hoyt <br /> PLUMBING MECHAIJICAL _ <br /> FEE <br /> NO. TYP[OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT _ _ <br /> WATER CLOSET Q-OILET) AIR CONU.UNITS—H.P.[A. <br /> REfRIGERATION UNITS—HP.EA — <br /> BATHTUB <br /> �pVATORY(WA511 BASIN) BOILERS—H P.EA. . <br /> GAS PIREO A.0 UNITS—TONNAGE EA. <br /> SHOVJQR __ <br /> FORCE�AIR SYSiEMS—6:LU. M EA. <br /> KITCHEN SINK 8 UISP. . <br /> WALL HEATERS—B T.U. M <br /> DISITYlASHER __ M <br /> UNIT HkATERS—B T.U. <br /> LAUNDHY TRAY __ <br /> EyqppRATIVE COOLERS <br /> CLOT.HES WASHER CIOTHES DRVERS _ <br /> WATER HEATER <br /> VENTILATION FAN <br /> 'JRINAL <br /> RANGEHOOD <br /> DRINKIYG FOUNTAIN — <br /> AIR HANDUNG UNIT— C.F.M. <br /> I'LOOR DRAIN _ STOVE — <br /> \'ACUUM BPEAHERS <br /> POOF GRAINS--RAINLEADERS <br /> METAL FlREPLACE 8 CHIMNEY <br /> SINK(SERVICE—BAR GTC.) <br /> — — SUBTOTAL 5 <br /> SUBTOYAI s <br /> PEfiMIT S PEHMIT <br /> 70TALFcE S TOTALFEE 5 <br /> PLAN CHECK FEE <br /> SIDE YARD SETBACK STREET SETBACK �� FEAR YAR�SETBACK PLAN CHECK NUAIBER �EE RECEIPT N0. <br /> USE ZONE LOT AREA VACANT SITE — FEES VALUATION FEE <br /> OYES ❑NO <br /> TYPc OF fANST. 7CCUPANCY GROUP NO.OF JWELLING UNIT`. — <br /> BUILDING a 1648.OU 1� 0� <br /> SIZE OF OLDG. NO.OF STORIES �+������n�� <br /> PIUM�ING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED _ <br /> ❑VES ❑NO <br /> ppPpOVALS <br /> B( DATE O7HER <br /> 1. ENVIRO!JMENTAL CHECK LIST PENALTV U.B C. <br /> SEC.3D3(a) <br /> 2. BUILOING!'lhMS TOTa� . 1] QQ <br /> 3. FIRE NYDRANT <br /> — PENMIT VALIDATION <br /> 4_FIRE PROTECTION SYSTEM WHEN PHOPEHLY VALIDP.TED QN THIS � o D �HIS IS��{R�F�.�� 0 "�� , <br /> 5. GR�DING o U I <br /> � <br /> 6. ORA�NAGE � <br /> 7. ENVIRONMENTAL IMPACT STqTEMENT Y�u � R.EGE�P�` <br /> 8. HEALTH DISTRICT t' �,^` <br /> APPLICATION ACC.�Y PLANS CMECKED BY APf'H.FOR ISSUPf10E BY �},�ij;i}.�K l��� O <br /> _� — , . 4 '. .. .. . . <br /> � '1 <br />