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dte E��eryrcen � �)N ST R U CT I 0 P+I <br /> CITY OF <br /> everett �ERMIT pEP.M1T N0. 1JH649 <br /> CITY HFLL 259�8745 <br /> eveaeTr.e:;. �eza� � COMBINATION i%� BUILDING � MECHANICAL PLUMBING <br /> GCINiH IAAILAUDNE55 U!T Z�0 pMOYc. <br /> Groeneveld, F. W. 8120 Lowell Larimer Road 98203 E13-?752 <br /> Ff�CMrtCGiOROCSIGNER MNI�F�DRE55 QiY Z�� PMONE <br /> GE��ERAI GONIRACTOP MAIL ADDRE55 CiiY ZIF PMONE LICENSE� <br /> Same <br /> MECi�A��iCAI CANTRACtOR IAAIL ADDFE55 CITY ZIP PF10NE UCENSE 1 <br /> PLUMBING LONTPACtOR IAFIL ADOFE55 CiTY Z'�P PHONE UCEHSE� <br /> CLA55 OF WORN <br /> �EW ❑ADDITION ❑ALTERATION ❑REPAIP ❑DEMOLITION ❑PENCE ❑SIGN ❑GARAGE <br /> VPIUAT10N OF WORK <br /> s 34, 000.00 <br /> DESCRIBE WOHK <br /> Construct single family residence <br /> rnCnoSED USE F Bun n+G <br /> sing�.e amily residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �.�:cs�oescr+i�rior+ocaaorearvisNowoeiowoar,rrr,a�rouacovies PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 27-28 307 Hilton' s lst ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HiS <br /> �or n�oc�_ov TYPE CF WOAK WILL BE COMPLIED WITH WHETHER SPEGRED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PR6- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATWG, <br /> 5 18-29-5 CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION <br /> sic��nrua[o� co��n�<ao; ci��,un�onizeor.,eirt nnte <br /> JO!1hUDRF55 � � II����(/� <br /> 1512 Hoyt X M o <br /> PWMBING MECHA C . <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> Z WATER ClOSLT ITOILET) Ptl1 COND.UNIiS-H P.EA . <br /> .L DATHTUd R6PRIGERATION UNI1S-HP.EA __ <br /> 2 �AVATORY ryJASH BASIN) r� OO OOILERS-H P.EA. _ <br /> SHOYlER GAS fIRED A C.UNITS-TONNAGE EA. ____ <br /> KITCHEN SINK 8 DISP. ], FORCED�IR SYSTEIAS-B T.U. M EA. 9_ <br /> 1 OISHWASHER WAILHEA7ER5-BT.U. M _ <br /> LAUN�RY TRAY UNIT HEATERS-�T.LL M _ <br /> I. CLOTHES W/.SHER ' EVAV`ORATNE COOLERS _ <br /> 1 WAT[R HEATER Z OO 1 CLOTHES OR�'ERS <br /> URINAL 2 VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD .5.�- <br /> FLOOR DRAIN AIR HAN�LING UNIT- CF.M. <br /> VACUUM BREAKERS STOVE — <br /> ROOF DRAINS--RAINIEADERS METAL FIREPLACE 8 CHIMNEY _ <br /> SINK(SERVICE-BAR ETC) <br /> SUB TOTAL SUB TOTAL f 21 OC <br /> PEFMIT S PERMIT s <br /> iOTAL FEE S 1 S TOTAL FEE f 2�. OO <br /> 31DE VARD SETBACK STHE[1 5[T�ACK REAR VARD SETBACK PLAN CHECN HUMBEfl PLAN CHECK F°E <br /> 5� 20 ' 20' 8649 ���131. 30 ��.��4�4d'� <br /> USE ZONE l07 nRE� vACrwT SITE FEES VALUATION FEE <br /> R-2 6200 Sq. Ft. �X�7€S �' �.No --- <br /> TYPE OF CONST. OCCUPANCV GFOUP NO.OF OWELLING UNITS _ <br /> V-N R-3 1 eui�oir+c 5 34 ,000 . 211 00 <br /> SIZL OF BLD6. N0.OF STOPoES MAX OS.LOAD — <br /> 4�� X94 � 1 PLUMB�NG 18 OO <br /> RRE ZONE BASEMENT FIRE SPRINKLERS MECHAN!CAL Z 1 O O <br /> None REOUIR.p�. _ <br /> iivEs irNa <br /> APPflOVALJ BY DATE OTNER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.8 C. <br /> SEC.3031a1 <br /> :. BUILDING PLANS '" <br /> TOTAL 350 00 <br /> 3. FIRE HYDRANT � <br /> a. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> \VHEN Pf70PERLY VALIDAT£D(IN THIS SPACE�THI515 YOUfl PERMIT <br /> � 5 GRADING 2 2 �� �� 8 �1 [ I I. O O — � <br /> '-'d. GHAINAGE , � <br /> � � . �] <br /> i t. ENVIRONMENTAL IMPA6FBTAiEM11ENT � �' � `7 � <br /> � <br /> �.0 HEALTH DISTRICT '_ `' .� i� I�._� � II T O <br /> �-�PPLICATION ACC.BY =(yANS CHECKEO BV APPR.FOR ISSUM�CE BY, , i I,,7 ; ,r'';,'�;; \' 4 � I <br /> � V <br /> -- I V.C. i <br /> __ -�� <br /> �� ., , <br /> � l J <br /> I;t�'J.-.':: f`ii._ <br />