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. <br /> theEvergreen " C(�STRUCTION � � <br /> CITY OF <br /> everett PERMIT PERMIT NO. G�ZO1 <br /> GTY HALL 259�0745 <br /> EVERETf,WA 98201 ❑ COMBINATION �7gUILDING ❑ MECHANICAL PLUINesiNG <br /> OWNER MAILAOORE55 CITY ZIP ✓'ANE . <br /> James R. Otto 250 Heather Road Everett <br /> ARGHITECT OR DESiGNER MAIL ApDRE55 CITY ZIP PHONF <br /> GENERAL LONTRAGTOR MAIL R�DRESS qTY 21P PHONE LICENSE� � <br /> Same <br /> MECHANICALCANTRALTOR MAILPOORE55 ��TY ZIP PHONE LICENSEI . <br /> PLUMBINGCANTMCTOP MAILADDRE55 Cltt ZIP PHONE UCENSE� <br /> CLASS OF WORK <br /> ❑NEW OA�DDITION ❑ALTERA710N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE — <br /> VALUATION OF WOPK <br /> f S �OQ�. �O <br /> �ESLPIBE WONK <br /> addition of deck <br /> PROPoSED VSE OF 9UILUING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- � � <br /> LEGAL DESCRIPfION OF PROPERTV ISMOW BELOW OP ARACH FOURCAPIES) PUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. . <br /> 13 5 States 3rd addition ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �ar ���C�_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED : <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT . <br /> PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPRO- . <br /> VISIONS OF ANY OTHFR STATE OR LOCAL LAW REGULATING � <br /> CONSTRUCTION OR THF PERFORMANCE OF CONSTRUCTION. � <br /> JOB ADUFE55 SIGNATURE Of CANTRACTOR OR AUtNOF12E�AGENT DATE <br /> � BJ12/80 <br /> 250 Heather Road X <br /> PLUMBINO MECHANICAL " <br /> NO. TYPE OF FI%TURE OB ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> WATER l'LOSET(TOILEn AIR COND.UNITS—H.P.EA. '� <br /> BATHTUB REFRIGERATION UNITS—H.P.EA � <br /> LAVATGRY(VJASrI BHSfN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS—iONNAGE EA. , <br /> �� KITCHEN SIHK 8 GISR FORCED AIR SYSTEMS—B T.J. M EA. <br /> � DISHWASHER WALL HEATERS—B.T.U. M � <br /> �. LAUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATI'JE COOLERS <br /> � WATEH HEATER CLOTHES DFYERS <br /> - � URINAL VENTILATION FAN �� <br /> - � ORINKING FOUNTAIN RANGE HOO� ' <br /> '' FIOOR DRAIN AIR HANDLING UNIT— QF.M. . <br /> VACUUM BREAKFRS STOVE <br /> ROOF�RAINS--RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE—BAR.EfC.) <br /> j SUBTOTAL SUB70TAL 3 <br /> � PEBMIT i PERMR f — <br /> � TOTAL FEE i TOTAL FEE f � <br /> SIDEVARD SETBACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> - � 80�$1�1. FE16.00 REC��7tltS4 <br /> �� USE ZONE LO7 AREA VACANT SITE FEES VALUATION FEE � <br /> ❑YES ❑NO <br /> 7YPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING $ �j ����. 0 3z QQ <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAU <br /> PLUMFWG <br /> FIRE ZONE BASEMEN7 pEOUIRED KLERS MECHANICAL <br /> OYES ❑NO <br /> � APPNOVALS BY UATE OTHER <br /> 7. ENVIRONMENTAL CHECK LIST pENALTY U.B.C. <br /> SEC.303(a) <br /> 2. BUIIDING PLANS <br /> TOTAL � 3 2 0 0 <br /> 3. FIRE HYDRANT � � <br /> 4. FIRE PROTEC710N SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VAII�ATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING 6 I 5 9 $ 0 3 2. 0 0 ��= � , <br /> 6. DRAINAGE <br /> 7. ENVIRONMENTALIMPACTSTATEMENT . � � <br /> 8. HEALTH DISTRICT � Y�•���� P R E C E I PT � <br /> 0 <br /> APPLICATIpN ACC.BY PLANS CHECKED 9Y APPR.FOR ISSUANCE BY . ; �"��\��C Y.O U <br /> V.C. • <br /> � 2 ;,uc 8 0 <br /> ADDRESS FILE � <br />