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, <br /> �he EverRreen -� C��y�T R U C�I O N � <br /> CITY OF <br /> everett P�R��� PERMIT NO. OHZ.S7 <br /> CITY HALL 259-8145 <br /> eveaeTr.v✓n 9ezoi ❑ COfJIBINATION x�tBUILDING ❑ fNECHAh�CAL ❑ PLUMBING <br /> 01'1NER M41L A�DNE55 CITY ZIF PMDNE <br /> John M. Waqv 2225 Jackson 98203 353-3112 <br /> nnCNrtECTOR0E51GNER MAILADDRE55 CITV 21P P��ONe <br /> GENERALCCNiqACTOR MRiLApDRE55 CITY ZIP PNONE LICENSEI <br /> Same <br /> MECMANICAICONRiACTOR MAILADDRE55 CITY 21P PHONE LICENSEf <br /> PLU6IBINGC�N'9ACTOR MAILAD�FE55 CIiY 21P PHGNE IICENSE� <br /> CLA55 OF 1VOPK <br /> ❑NEW ❑ADDIT�ON �3G.TERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VhLUAT10N OF WORK <br /> s 2. 214 .00 <br /> CESCPoAE WORK <br /> Gable roof over flat roof <br /> PHOPOSED USE OF OUILUING <br /> single family residence I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THISAP� <br /> ieca�oescaianoNOFPr+oa=_nrr,s�owee�awoanrrncHFouacoviesi PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 25-29 30 Pi��ehurst ALLPROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS <br /> �or__o�ocK_oF _ - TYPE OF WORK WILL BE CONPIIED WITH WHETHER SPEGFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> — VISIONS OF ANY OTHEq STATE OR LOCAL LAW REGULATIIvu <br /> CONSTRUCTION OR TFIE PERFORMANCE OF CONSTRUCTION. <br /> IOPAODRE55 SIGNAIUREOF NTRFCTOFORFUTNORIZEUAGCFli IJATE <br /> 2225 Jackson X ��_ `�a 8/21/80 <br /> PLUMBING MECHANICAL � <br /> NO. 1'YPE OF FI::TURE OR ITEM FEE NO. TYPE OF E�111FMENT FEE <br /> WATER CLOSET(TOILETI AIR COND.UNITS—H.P.EA. <br /> BATHTUB FEFRIGERATION UNITS—H.P.EA <br /> LAVAiORY hVASH BASIN� BOILERS—HP.EA. <br /> SHOWER GAS FlREO A.C. UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISR FORC[D Alq SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALL HEATERS—67.U. M <br /> IAUNDRY TPAY UNIT HEATERS—8.T U. M <br /> CLOTHES WA$HER EVAPORATNECOOLERS <br /> V/A�ER HEATER CLOTHES DRYERS <br /> URINA_ VENTILATION FAN <br /> ORINKING FOUNTAM .F7ANGE HOOD _ <br /> FLOOR G�AW � AIR HPNDLING UNIT— GF.M. <br /> VhCUUM BRlAKERS STOVE <br /> ROOF DRAIGS—RAINLEADERS METAL FlREPLAC[8 CHIMNEY <br /> SWH(SERVICc�—BAP.ETC.) <br /> SUBTOTAL SUBTOTAL f <br /> PERMIT f PEHMIT S <br /> TOTAL FEE 3 TOTAL FEE f <br /> SIDE VARD SETBACK STREET SETBACK REAR YAnU SET9ACK PLAN CHECK NUMBER PLAN CfiECK FEE <br /> FEE RECEIPi NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> [7YSS ❑NO FEES VALUATION FEE <br /> TYPE OF COVST. OCCUPANCY GHOUP NO.OF DWELLING UNITS <br /> BUILDING $ z , 214 . 29 0� <br /> SIZE OF BLDG. NO.OF STORIES MN(.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL <br /> []YES ❑NO <br /> APPflOVALS BY DATE OTHER <br /> t ENVIRONMENT.4L CHECK LIST PENALTY U B.0 <br /> SEC.303(a) <br /> 2. BU4D!NG PLANS — <br /> 3. FIRE HYDRANT TQTA� Z�I OO <br /> a. FIRE PROTECTION SVSTEM PERMIT VNLIDATIUN <br /> — WHEN PROPERLY VALIDATED pN THIS SPACE)iHIS IS VOUR PFRMR <br /> 5. GRADING 6 6 5 0 � O � 4, O � 1�'� �"' <br /> 6. DRA�NAGE M <br /> '!. ENVIRONh1ENTAL Il.1PACT S7ATEMENT c--� <br /> 8. HEALTHDISTRICT " ;� r � <br /> � _ i; �•. R:_C�IPT o <br /> APPUCATION.\CC.BV Pll�NS CHECKE�0Y APPR.FOR ISSUANCE�Y <br /> ' i��,"���.��. �I lJU <br /> � � "'� �'U <br /> „�6 <br /> i1DDRESt FILE <br />