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9 <br />the Evergreen <br />CITY OF I ' PO N ST R U CT I O ICI <br />CITY <br />everett PERMIT PERMIT NO. 14202 <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Arline Bovee 5214 226th N.W. Stanwood 96292 652-8303 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />PLUMBING CONTRACTOR <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR Cl DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE)FIREPLACE INSERT <br />VALUATION OF WORK <br />$ 3,947.00 <br />DESCRIBE WORK <br />repair foundation <br />PROPOSED USE OF BUILDING <br />Btwo family residence <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 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 NTgq TOR OR AUTHOR( 0 ACE 1 DATE <br />X e <br />TS <br />LEGAL DESCRIPTION OF PROPERT(SHOW BFLCW O^ ATTACH FOUR COPIES, <br />9-10 214 Bailey <br />LOT -BLOCK -OF <br />— <br />_ <br />JOB ADDRESS <br />1015 Grand Avenim <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 - H.P. EA. <br />LAVATORY(WASH BASIN) <br />BOILERS -- H.P. EA. <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 - C.F.M. <br />VACUUM BREAKERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />I METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR. ETC.) <br />FIREPLACE INSERT <br />MEAT PUMP <br />SUB TOTAL <br />s <br />SUB TOTAL s <br />PERMIT <br />s <br />PERMIT s <br />TOTAL FEE <br />f <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />N/A <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />84/14202 <br />PLAN <br />FEE 28.93 <br />CHECK FEE <br />RECEIPT NO. <br />701OA <br />USE ZONE <br />R-2 <br />LOT AREA <br />VACANT SITE <br />YES XX40 <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />BUILDING <br />s 3947. <br />SIZE OF BLDG. <br />.643 Sq. Ft. <br />NO. OF STORIES <br />2 <br />MAX. OCC. LOAD <br />5 <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 />44 <br />50 <br />3, PRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS JS YJU P RMIT— (U <br />I FT (_JI <br />- ) <br />N <br />S. GRADING <br />6. OHAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />gPPI (CATION ACC. BY <br />PLANS CHECKED BY <br />APPR.. OR ISSUANCE BY <br />If L 1 <br />r'DDRFSS r � (. <br />z <br />0 <br />-H <br />n <br />m <br />m <br />1_ -4 <br />