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Ike Everown <br />CITY OF <br />everett <br />CITY HALL 2W 745 <br />EVERETT, WA 9820 <br />.9ONSTRUCTIOK" <br />PERMIT <br />FLI COMBINATION 0 BUILDING ❑ MECHANICAL <br />PERMIT NO. i5222 <br />❑ PLUMBING <br />MAIL ADDRESS CITY ZIP PHONE <br />Pat Blaine 1828 Highland Avenue Everett 98201 259-5362 <br />MAIL ADDRESS CITY ZIP PHONE <br />GENERAL <br />BaBCO MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />fiNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S 3,000.00 <br />oEBCIBBE Vxm <br />Oonstruct Garage <br />PROPOSED USE OF SUILNNG <br />Single Family Residence <br />I HEREBY CERTIFY THAT I HAVE READ i ) EXAMINED THIS <br />APPLICATION AND KNOW THE SAME 0 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 OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />LFOAL DESCRIPTION OF PROPERTY (SNOW BELOW OR ATTACH FOUR COPIES) <br />235� St. Nicholas <br />Lor_eLocK_oF <br />JOB ADDRESS <br />1828 Highland Avenue <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 — M.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA, <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK S WSP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <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 6 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />B <br />SUB TOTAL $ <br />PERMIT <br />S <br />PERMIT S <br />_ <br />TOTAL FEE <br />B <br />TOTAL FEE E <br />SIDE YARD SETBACK <br />5' <br />STREET SETBACK <br />20' <br />REAR YARD SETBACK <br />r <br />PLAN CHECK NUMBER <br />85/15222 <br />PLAN <br />FEE 13.23 <br />CHECK FEE <br />40 N0. <br />USE ZONE <br />R-2 <br />LOT AREA <br />VACANT SITE <br />::YES no <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />N <br />NO. OF DWELLING UNITS <br />N/A <br />BUILDING <br />S 3,000. <br />38 <br />50 <br />SIZE OF BLDG. <br />308 SQ. Ft. <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />N A <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />'YES '-NO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2 BUILDING PLANS <br />TOTAL <br />38 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPADE) THIS IS YOLA PERi?IL— cl4 <br />N <br />N <br />Ln <br />I <br />S GRADING <br />S DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT. <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />hwm <br />APPR. FOR ISSUANCE BY <br />lC <br />ADDRESS FILE <br />