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1nrE'CRYOF ' - CONSTRUCTIO' I <br />everett PERMIT PERMIT NO. 13251 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 ❑ COMBINATION BUILDING ❑ MECHANICAL C PLUMBING <br />OWNER MAIL ADDRESS CITY Zip PHONE <br />Edwin Coon 2621 Hillside Lane Everett 98203 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Cascade Millwork 4716 College Everett 98203 252-4871 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE <br />❑ NEW XXADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S 500.00 <br />•nc4aTT .. ..A....,.. <br />PROPOSED USE OF BUILDING <br />Single Family Residence <br />I HEREBY CERTIFY THAT I HAVE HEAD 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 OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTA 'TION. <br />SIGNATURE F CONTRACTOR OR IZED GENT DATE <br />GfGiJ 4/18/84 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT —BLOCK —OF Seaview Heights <br />JOB ADDRESS <br />2621 Hillside Lane <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 - M.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY (WASH BASIN) <br />I <br />BOILERS - H.P. EA. <br />_ <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK & DISP. <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 - G.F.M. <br />VACUUM BREAKERS <br />STOVE - WOOD <br />RCOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />3 <br />Water Faucet <br />6, <br />HEAT PUMP <br />SUB TOTAL <br />f <br />6 <br />00 <br />SUB TOTAL $ <br />PERMIT <br />f <br />PERMIT S <br />TOTAL FEE <br />T <br />6 <br />00 <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />::YES ENO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CLNST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f 500. <br />10 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />6 <br />00 <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 />16 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />IT WHENPROPIERLYYVALIDATED UN TI AIe PPAGE) TMI hS,YfI}(i P�Fj�.11T <br />UU YY UU UU �IJJ UU UU <br />N <br />m <br />`1• 1 � i R'-C 6 I PT � <br />YCU <br />5. GRADING <br />-B. DRAINAGE <br />. ENVIRONMENTAL IMPAGESTATEMENT <br />zr8. HEALTH DISTRICT O <br />APPLICAYI ;A C. BY <br />m <br />C _ <br />PLANS CHECKED BY <br />JEF�`T1"�1\ <br />APPR. FOR ISSUANCE BY <br />cL) <br />ADDRESS FILE <br />1 9 APR 8 4 <br />L- <br />