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�he£�•eiRreen • �O N ST R U CT I O� ! <br /> ��T�aF � <br /> everett PERMIT PERMIT NO. 1512Z <br /> CITV MALL 259�F7a5 <br /> EVERETT,WA96201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MpILF00RE5S CITY 21P PHONE <br /> Richard & Irene Gregozy 2218 Eaet Grand S�uuQ Everett 98201 259-5510 <br /> ARCMITECT OR DESIGNER MAIL ADDflE55 CITY ZIP pMONE <br /> GENER�LCONTRAGTOR MAILADORE55 CITY IIP PNONE LICENSEI <br /> Self <br /> MEGHANIGAL CONTRAGTOR MAIL ADDRE55 CITY 21P VHONE LICENSE/ <br /> PLUMBING CONTRACTOR MAIL AUDRE55 CITY ZIP PHONE LICENSE I <br /> CU55 OF WORK <br /> O NEW ❑ A�DITION � ALTERATION fC]REPAIR O �EMOLITION ❑ FENCE ❑ SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VA�UATION OF WORN <br /> f 7��.�0 <br /> DESCHIBE WOPK <br /> Re-roof <br /> FROPOSE�USE OF BUILDING <br /> Single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPEPTV�SHOW BE�OW OR ATTACH FOUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �oTZ3_Z�LOCN 459 oF Altamont 2nd Add. of Everett GOVEANING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.1'HE 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 LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRE55 SIGNATIIR OF CONTRACTOR OR qlRyORIZED T OATE <br /> 2218 East Grand C <br /> PLUMBIN� MECNANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENi FEE <br /> WA'�ERCIOSET(TOILEn AIR COND.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P. EA. <br /> LAVATORY(WASH BASIN) BOILERS — H.P. EA. <br /> SHOWER GAS FIREO A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINKd DISP. FORCED AIR SVSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRYTRAY UNI7 HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER MEATER CLOTHES ORYEFiS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERC METAL FIREPLACE 8 CHIMNEY <br /> SINK(SEPVICE— BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUBTOTAL a SU8 TOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE f TOTALFEE f <br /> SIDE YAiiD SETBACK STqEET SE7BACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECE!PT NO. <br /> USE ZONE LOT AREA VACANT SI7F <br /> r�.ycg r:Np FEES VAIUATION FEE <br /> TYPE OF CONST. OCCUPANCY�ROUP NO.OF�WELLING UNI7S <br /> BUILDING S70Q.Q� 13 QD <br /> SIZE OF 9LDG. NO.OF STORIES MAX.OCC. LOAD — <br /> PLUMBING <br /> FIREZONE BPS�MENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> .-�YES : :NO <br /> APPROVALS BY DATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST pENALTY U.B.C. <br /> 2.BUILDING PLANS SEC.30J(a) <br /> 3.FIREHYDRANT TO7AL 13 00 <br /> 1.FIRE PROTECTION SYSTEM pEHMIT VALIUATION <br /> 5.GRADING WHEN PROPEPLY VALIDATED(IN THIS SPACE)THIS IS VOUR PEtiMIT (V <br /> P ORAINAGE N <br /> 7.ENVIHONMENTALIMPAC75TATEMENT � <br /> 8.HEALTH DISTRICT � <br /> APPUCATION ACC.BY PLANS CMECKED BY APPR. FOR ISSUANCE BY <br /> M.M. L.C• <br /> ADDRESS FILE <br />