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Ihe Ect'rqreen <br /> e�ere�� � �ONSTRUCTIOr.. <br /> PEl�MIT PERMIT N0. l �' � � -�, <br /> CITV NALL 2v9�8i»5 <br /> EVER�TT.WA 99201 � COMBINATION � BUILDING ❑ MECKANICAL ❑ PLUMBING <br /> OWNER IAA�I.p0�RE55 QTY ZIP PMCNE <br /> DIRS RICE 19112 - 69th PL 14 Lynmaood l5'A 98036 778-1787 <br /> PPCMRECi OR OESIGNER MAL p00RE55 GTY ZIP 2HOP:E <br /> GENERnLCONiRAGiOP lEAILFOVRE55 GIiY ZIP �,.ONE LIGENSEr <br /> RIVERSIDE ROOF CO 2916 State St Everett 14A 98201 258-4646 RIVERI2302KD <br /> MEGHANIGRL CONTRFCTOR MhIL FO�PE55 CITY ZIP PHONE LILENSE• <br /> PWMBING LONTRAGTOR MAit.p00RES5 CIiY ZIP PHONE L�GENSE M <br /> CLPSS OF WORN <br /> ❑NEW O A7DITION ❑ AL7ERATION '�REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIFEPLACE INSERT <br /> VA!UATION OF WORK <br /> = 28��.�� <br /> DESCHIDE WORH 2 <br /> Hot built up roof �� <br /> H <br /> PNOPOSFG IISE OF BUILOIN3 (� <br /> ReSideriCe I HEREBY f:ERTIFY THAT I HAVE READ AND EXAMINED THIS c� <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> ..'cGAL�ESCRIP�ION OF PROPERTY�5'�OW BELOW OR ATTAGM FOOP COPIES� CORRECT. ALL PROVISIONS OF LAWS AIJD ORDINANCES <br /> �or_(2,e!.ocK�.LZ.aF_ InterclYJ' Div GGYERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> 4'/HETHER SPECIFIED HEREIN OR NOT.THE GRA�!TING OF A <br /> PERMIT DOES NOT PRESUME TO Gi JE AUTHORITY TO VIOLA?F i..� H <br /> OF CANCEL THE PROVISIONS OF AN'f OTHER Sl'ATE OR H �n <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE � y <br /> PERFORMANCE OF CONSTRUCTION. �] <br /> JOBAODR��� Intercity SIGNATUREOFCONiFACTOFOPAUTMOFIZEDAGENT h/Z9��5 � <br /> X��-{�I,t)�1- y <br /> PLUMBING MEC NFfA ICAL� O <br /> NO. TYAE UF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE _ � <br /> I NIATERCLOSET�TOILEn 41R COND.UNITS-- M.B EA. H <br /> BATHTUB REFRIGERATION UNIiS - H.F.EA. � z <br /> LAVATORY�WASM OASIN) BOILERS - N.V. EA. � H� <br /> _ SMOWFR GAS FIRED A.C. UNITS-TONNAGE EA. y ~ <br /> K � <br /> KITCHEN SINK 8�ISP. F09CE0 AIR SVSTEMS- B.T.U. A1 EA. � <br /> DISHWASHER WALL HE4TERS- B.T.U. M � <br /> LAUNDRYIRAV UNIT HEATEflS- B.T.U. p9 � <br /> CLOTHES WASMER EVAPORATIVE COOLERS � ,y <br /> WATER MEATER CLOTHES DRVERS `� <br /> URINAL VENTILATION FPN � �� <br /> ORINKING FOUNTAIN RANGE HOOD G � <br /> _ FLOOR DflAIN AIR HANDLING UNIT- C.F.M. � � <br /> VACUUM BPEAKEFS STOVE-WOOD <br /> ROOF DRAINS- RAINL[ADERS METAL FIREPLACE&CMIMNEV <br /> SINK(SEFVICE - BAR,ETC.) FIREPIACE INSERT � <br /> MEAT PUMP <br /> — � <br /> - H <br /> � <br /> SUB TOTAL S S118 TOTAL S �y <br /> PERMIT S PEHMIT S b <br /> TOTAL FEE S TOTAL FEE f � n <br /> SIDE V4R0 SETBAGK STREET SETBACK flEAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE ��� <br /> FEE I RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE – ' <br /> .YES NO FEES VALUATION FEE <br /> LYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING 5 ZSOO.00 3H SO <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD — <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRIIJKLEpS MECHANICAL <br /> flEOUIRED <br /> VES NO <br /> APPROVALS BV OATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENA�jY U.B.C. <br /> SEC.70J la� <br /> 2.dUiiDING PLANS --- <br /> 3.FIPEHYDHANT T�TA� ?H SO <br /> 4.F�AE PROTECTION SYSTEM PEflM1T VALIDATION <br /> 5.C�RADING WMEN PRUPERLY VALIDATED(IH THIS SPACFj THIS IS YOUR PERMiT �. <br /> 6.URnINAGE � <br /> N <br /> 7. :NVIRONMENTAL I MPACT STATEMENT �. <br /> 8 HEALTH DISTRICT ' ,'...+ <br /> APPIICATION FCG FIY PLANS CHECKED DY APPR.FOR ISSUANCE�Y <br /> °�I;fliCl_:� FIV. <br />