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t.Ye Evergreen CITY OF `"O NSTRU CTIO N <br />elvereit PERMIT PERMIT NO.1.0315 <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 ® COMBINATION ® BUILDING ® MECHANICAL PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />JD1Tn Monroe <br />4621 Hoyt Avenue <br />Everett <br />98203 <br />252-9740 <br />ARCHITTI'T RDESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />LICENSE♦ <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />".. Vl'• ❑NEW b&¢DDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑GIGN ❑GARAGE <br />s 10,900.00 <br />Addition of Dining Room <br />PROPOSED U5E OT- UUILUING <br />Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />LEGAL DESCRIPTION OF PROPERT" (SHOW ULLOWDR ATTACH POUR COPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LOT 25-?L@CK lOOF Central Park 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 0,F ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRU TI OR THE PERFORMANCE OF CONSTRUCTION. <br />JOB ADDRESS SIGTI ", OF Ni A i OR AUTHORIZED AGENT DATE <br />A 91 q ,,,+- Alta T111a Y I QCI _ft 15 <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 />AIP CONU. UNITS — H P. EA. <br />BATHTUB <br />REFRIGERATION UNITS— H.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />SHOWER <br />1 <br />KITCHEN SINK 6 DISP. <br />2 <br />00 <br />FOPCED AIR SYSTEMS — B.T.U. M EA <br />1 <br />DISHWASHER <br />2 <br />00 <br />WALL HEATERS —B.T.0 M <br />_ <br />LAUNDRY TRAY <br />uNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHE! DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RAN OE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />METAL FIREP:ACE & CHIMNEY <br />ROOF DRAINS — RAIN LEI S <br />SINK (SERVICE — BAR. ETC) <br />SUBTOTAL <br />4.00 <br />SUBTOTAL <br />S <br />4 <br />50 <br />PERMIT <br />$ <br />PERMIT <br />S <br />4 <br />5 0 <br />TOTAL FEE <br />$ 4 nn <br />TOTAL <br />I:EE <br />S <br />_ <br />SIDE YARD SETBACK STREET SETBACK <br />PEAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />620' <br />20' <br />82/10315 <br />FEE 56.23 <br />RECEIPT 140. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES W <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />TYPE OF CLNST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />5101900. <br />86 <br />50 <br />V-N <br />R-3 <br />1 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />4 <br />OO <br />10 I X15 T Add <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED __ <br />MECHANICAL <br />4 <br />50 <br />None <br />❑VES IiPX1 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECKLIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS p <br />TOTAL <br />95 <br />CO <br />p <br />3. FIRE HYDRANT <br />A. FIRF. PROTECTN SYST¢M <br />p T� <br />iIE T F RAT^y'pALID& (IN THIS SPACE) THIS IS YOUR PERMIT <br />VVFF��hh1l�� p�q o o s s $ 0 8 L. 5 0 <br />}Z <br />;.�.,;r YOU YOUR RECEIPT <br />" ' THANK K Y O U <br />—_— <br />5. GRADING! :'T <br />T. DRAINAGE •_ <br />rS <br />7. ENVIROLMENTAL IMP AC TATEMENT <br />• • -. 1 <br />H LTHLTH'{DISTRI.?T =" <br />• <br />CARPLICATIOkAC�BY <br />O NS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />c. <br />E �_V_ <br />K.C. <br />4 LAR 32 <br />