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�he E verRreen <br />��,�o� <br />everett <br />CITV MALL 259�67d5 <br />EVEPETT, WA 98207 <br />�ONSTRUCTiOM� <br />PERMIT <br />❑ COMBINATION xl�c BUILDING ❑ MECHANICAL <br />PERMIT NO. 15��4 <br />❑ PLUMBING <br />OWNER MAIL ADORESS (:ITY ZIP PMONE <br />Reider Harmer 250 Highla-nd Road Everett 353-6859 <br />ANGNITE.T OR DESiGNER MnIL nDJRESS CITY IIP PMONE <br />GENEPA�GONTRRCTGfl MAILF�ORE55 CIT" ZIP PMONE LICE�IfiE1 <br />James Camp Construction 207 188th N.W Arlington 98223 652-8239 <br />MECN�NICA� CONTPACTOR MAIL ADDRESS CITV � RZy,� � JC G�ONf. � yIIC,ENSE I <br />P (O 'l <br />PLUMBING GONTRAGTOR MAIL AO�RESS CI1Y 7.IP PHONE UCENSE N <br />O NEW ❑ ADOITION � ALTERATION ❑ REPAIR ❑ DEMOLITION .� FENCE ❑ SIGN O WOOD STOVFJFIREPLACE INSERT <br />VALUATION OF WONN <br />S 13rrJ00.�� <br />Lower Ceilings, Remove wall-small Addition <br />SED USE OF BUILDING <br />�or 1 o�ocn_oF <br />JOB <br />250 Highland Road <br />PLUMBING <br />ran's Addition <br />TYPE OF FIXTURE OH ITEM <br />W ATER CLOSET �TOI LEn <br />BA7HTUB <br />LAVATOFV�WASH BASIN� <br />SHOWER <br />KITCliFN SINK 8 DISP. <br />DISHWASHER <br />LAUNDPYTRAY <br />GLOTHES WASHER <br />WATER MEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOH DRAIN <br />VACUUM BREAKERS <br />qOOF DRAINS — RAINLEA�ERS <br />SIhK(SERVICE — BAR,E7Q) <br />6' <br />USE ZOIJE <br />R-1 <br />TYPE OF CONRI <br />V-N <br />SIZE OF BLDG. <br />145 Sq. Ft <br />FIRE ZONE <br />PERMII <br />TOTAL FEE <br />, STREET SETBACK <br />20' <br />LOT AREA <br />OCCUPANCY GRC <br />R-3 <br />NO. OF STORIES <br />Ad 'n 1 <br />BASEMENT <br />APPROVALS <br />1. LNVIRONMENTAL CHECK LIST <br />2. BUILDING ?LANS <br />3. FIRE HYDRANT <br />4. FIRE PROTEC710N SYSTEM <br />5. GFlADING <br />6.ORAINAGE <br />7.ENVIFONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. 6Y PLANS CHEC <br />F1SQM <br />FEE <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 8E COMPLIED WITH <br />WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STpTE OR <br />LOCAL LA1N REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CO RUCTION. <br />81GNATURE t�F CQNTRACiOR OR Ui OFIZED AGENT �- J DATE <br />NO. ' TYPE OF EOUIPMENT <br />AIR COND. UNI75 — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILEflS — H.P.EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — e.T.U. M EA. <br />WALL HEATERS — B.7.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORAi1VE COOLERS <br />CLOTHES DRYEPS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANOLING UNIT — C.F.M. <br />STOVE — WCOD <br />IdL7AL FINEPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />I1EAT PUMP <br />S <br />S <br />S <br />EAR YARD SETBACK PLAN <br />ACAN7 SITE <br />YES XXNO <br />0. OF DWELLING UNITS <br />SUB TOTAL <br />TOTAL FEE <br />85/k5084 IFEE 67.93 <br />FEES VALUFTION <br />1 BUILDING <br />MAX. OCQ LOAO <br />N/A PLUMBING <br />FIRE SPRINKLERS MECMANICAL <br />REOUIRED <br />YES . <br />BY DATE OiHER <br />PENALTV <br />I,C <br />BY <br />$ 13 <br />�a� <br />S <br />S <br />S <br />ree <br />REGEIPT NO. <br />FEE <br />TOiAL I I 109I SO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED �1N THIS SPACE) TMIS IS YOUR PERMI7 � <br />� � _ — � <br />� <br />Ll� <br />c-1 <br />