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the £cergreen _ <br />UTY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 ❑ COMBINATION <br />rONSTRUCTION <br />PERMIT <br />[�& BUILDING ! MECHANICAL <br />PERMIT NO. 14204 <br />PLUMBING <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Cornelius H. Quist <br />5002 N.E. 188th Seattle <br />98155 <br />362-4682 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE 0 <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE# <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE # <br />I.AJIIEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE)FIREPLACE INSERT <br />$ 10,000.00 <br />DESCRIBE WORK <br />Two Story Frame Structure <br />PROPOSED USE OF BUILDING <br />Livestock <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS 1F ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CO <br />s+agASTRORIUCTIO . <br />�RAC RORA ' <br />X I' TU _D NTZED NT 1 <br />21 ATE <br />LEGAL DESCRIPTION OF PROPERTY(CHOW BELOW OR ATTACH FOUR COPIES) — <br />LOT_SLOCK__OF <br />JOB ADORERS <br />7821 Larimer Road <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 />AIR COND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS - H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUBTOTAL 3 <br />SUB TOTAL S <br />PERMIT 31 <br />PERMIT S <br />TOTAL FEE $ <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />STREET SET BACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />84/14204 <br />L <br />PLAN <br />2.33 <br />CHECK FEE <br />RECEIPT NO, <br />72 9q- <br />UCE ZONE <br />A-1 <br />LOT AREA <br />VACANT SITE <br />eves Xko <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />M <br />NO. OF DWELLING UNITS <br />0 <br />BUILDING <br />$10,000. <br />80 <br />50 <br />SIZE OF BLDG. <br />281 x361 <br />NO. OF STORIES <br />2 <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />0 <br />FIRE SPRINKLERS <br />REOUIRED <br />❑YES ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (B) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />80 <br />50 <br />.1. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT__ <br />C\1 <br />. K:d- <br />S. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICATIO14 ACC. BY <br />EB <br />PLANS CHECKED BY <br />JEF <br />APPR. FOR ISSUANCE BY <br />LC <br />ADDRESS FILE <br />