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the Et�er,�reen <br /> ��'���.- �� �ON�TRUCTIO (� � <br /> everett IP��1M � 1 PERMIT N0. 1 �1 �1 <br /> CITY HALL 259�&7d5 <br /> eveaerr. wn9azoi � LOMBINATION � BUILDING ❑ MECHANICAL ❑ PLUtdBING <br /> OVJNER IAAIL ADDRES$ QTY ZIP PHON <br /> Pieter Kok 7414 Juniper Drive Sverett 353-14�40 <br /> ARCHITECT OR OESIGNER IdAIL AD�RE55 CITY ZIP PHONE <br /> GENEFAL GONTRACTOfI MAIL ADDBE55 CITV ZiF FHONE �ICENSE� <br /> State Roofing & Insulation P.O. Box 53 Monroe 9gZ7z <br /> MECMANICALCONTRALTOR MAILAppRE55 CITY ZIP oqON[ �,ICENSEr <br /> ST AT ERI 194 R3 <br /> PWfA9RIG CONTPlCiOR MAIL AODRESS GiY ZIP PMONE LICENSE� <br /> CLA55 OF WORK <br /> C NEW ❑ ADDITION ❑ q�7ERATION j[�REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALUNTION OF WOPK <br /> s 3,000.00 <br /> oesw�ae woaK <br /> re-roof--three ply hot tar <br /> PROPOSED USE OF BUILOItJG — �- <br /> Sir.gle Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGAL OESCBIViiON OF PROPERTY�SMO1V pELOW OR ATTACH FOUP COPIES� APPLICATION AND KNOJJ THE SAME TO 6E TRUE AN� <br /> COFRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT__BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIIJ OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFSJR ANCE OF CONSTRUCTION. <br /> dou n��oaess sicr�xfURE 7TFAC R Ofl FUiHOR12E0 AGENT pqTE <br /> . � � _1414 Junipar DRive X� ; ` T �/zz/es <br /> PI.:11dBING MECHANICAL � <br /> NJ. _ TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE _ <br /> VATERCLOS°7(TOILEn AIR COND.UNITS— H.P. EA. <br /> BFTIiTUB qEFRIGEflAT�ON UNIIS — H.P.EA. <br /> LAVl�TORY(WASHBASIN) 601LERS — H.P. El+. <br /> SH07JER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITC.iEN SINK 8�ISP. FORCED AIR SYSTEMf — B.T.U. M EA. <br /> DISHNASHER WALL HEATERS— B]'.U. M <br /> LAU�;DRV TRAY UNIT HEATERS— B.T.U. M <br /> _ CLO�'HES WASHER EVAPORATIVE COOLERS <br /> WAT_R HEATER CLOTHES DRYEflS <br /> _ UflINAL VENTILATION FAN <br /> DRINKING FOUNiAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM �qEAKERS STGVE-- WOOD <br /> ROOF DR.4;NS— RAINLEADERS METAL F19EPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR,ETQ) FIREPLACE INSERT <br /> HEAT PLNP <br /> SUB TO7!L S SUB TOTAL 5 <br /> PERMIT f PEflMIT s <br /> TOTAL FEE S TOTALFEE 5 <br /> SIDE YARD SETBACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT N0, <br /> USE ZONE LOT AREA VACANT SITE <br /> � .YES ,.NO FEES VAWATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING 5 39 50 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPPINNLERS <br /> REOUIRED MECHANICAL <br /> YES . NO _ <br /> APPflOVALS 6Y DATE OTH[F <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B C. <br /> 2.BUIL�ING PLANS SEC.303(a) <br /> �.FIREHY�RANT TOTAL 3H SO <br /> a.FIFE PflOTECTION SYSTEM PERMIT VALIDATION ' <br /> 5.GRADING WHEN PROPERLY VALIDATED QN THIS SPACE)THIS IS YOU�7 PERMR .r-� <br /> 6.ORAINAGE - ' �— � <br /> �.ENVIRONMENTALIMPACTSTATEMENi �--� <br /> 8.HEALTH DISTqICT I17 <br /> APPLICATION ACC. BY PLANS CHECNED BV APPR. FORISSUANCE 8Y : � <br />