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, , <br /> � <br /> �heEvcg oF - CO'NSTRUCTION "� -� <br /> everett PERMIT pERMIT NO. OHO69 <br /> GTY HALL 259�0745 <br /> EVERETT,WA 98201 ❑ COMBINATION �BUILDINO ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILAOORESS CITY 21P PHONE <br /> irry S. Metzger 307 Central Building Everett 98201 252-9851 <br /> ARCHIIECT C �ESIGNEfl MAII ADDRESS CITV 21P PNONE <br /> GENEfUL CANTqApTOR MRIL AO�RESS CITY 21P PMONE UCENSE I <br /> Same <br /> MECMANICALCONiMCTOR MAILAODRE55 GITV ZIP PNONE LIf.ENSE/ <br /> PLUAIBINOCONTRACTOR NRILAOORE55 LITY 21P �'NONE LICENSE/ <br /> ClASS OF WOiil( <br /> ❑NEW ❑ADDITION ❑ALTERA710N }�REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> f 1�}00.�� <br /> DESCPIBE WdM( <br /> re-roof shake <br /> PROPOSED USE OF BUILDING <br /> Sinqle family resi9ence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> LECvLLDESCNIPfqNOFPROiERTY15MOW BEIONIroATTACNFOURfAPIES� PL:CATION AND KNOW THE SAME TO BE TPUE AND CORRECT. <br /> 5-6 Chuzch & LaMourea ALLPROVISIONSOFLAWSANDORDINANCESGOVERNINGTHIS <br /> �orZ,�.,reioc�oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOCS NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO� <br /> VISI OF ANY OT S TE OR L AL LAW REGULATING <br /> CO UGTION OR P R OR AN OF CONSTRUCTION. <br /> SIGN U E F CONTRACTOR HOR ED AGE DATE <br /> �8��4 Grand X „ 8/7/80 <br /> � PLUMlINO MECHANICAL <br /> N0. TYPE OF FIl(TURE OR ITEM FEE NO. TYPE OF EDUIPMENT FEE <br /> WATfR ClOSET OILEn AIR CAND.UNITS—H.F�.EA. <br /> aqTMTUB REFRIGERATION UNITS—H.P.EA <br /> � UVATORV ASH BASIN BOILERS—H,P.EA. <br /> �Ep GAS FIRED A.C.UNI7S—TONNAGE EA. <br /> � KITCNEN SINK 8 DIFP. FORCED AIR SYSTEMS—B.7.U. M EA. <br /> � , D16MWA&iER WALL HEATERS—B.T.U. M _ <br /> � . UUNDRY TMV UNIT HEATERS—B.T.U. M <br /> � CLO7MES WASHER EVAPORATIVE COOLERS , <br /> � yy��q H��p CLOTHES�RVERS <br /> I �p��� VENTILATION FAN <br /> � DRINKIN�FOUNTAIN RANGE HOOD ' <br /> ! FLOOR DMIN AIR HANDLING UNIT— C.F.M. <br /> � VACUUM BRFAKERS STOVE <br /> ROOF DMINS—MINLEADERS ME7AL FIREPLACE 8 CHIMNEY <br /> i SINK RVICE—BAR.ETC.) �� <br /> { <br /> �, 8UlTOTAL SULTOTAL S �. <br /> � PERMR f PERMIT S � <br /> TOTALFEE TOTALFEE � <br /> SIOE VARD SETBACK STREETSETBACK REAR YAPD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE ', <br /> FEE RECEIPT NO. � <br /> � USE ZONE LOT AREA VACANT SITE ; <br /> ❑YES ❑NO FEES VALUATION FEE <br /> NPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> SV.cOFBLDG. NO.OFSTORIES MA%.00C.LOAD BUILDING 51200 .00 12 00 , <br /> PLUMBING <br /> PIHE 1CNE BPSEMENT FIRE SPHINKLEPS <br /> REOUIRED MECHANICAL <br /> �YES ❑NO <br /> �yp�pyu{ !Y DATE OTHER <br /> 1. ENViRONMENTALCHECKLIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2. BUILDINGPtANS ' � <br /> 3. FIRE HYDRANT TOiAL 12 00 <br /> 4. FIRE PROTECTION SYSTEM PEPMIT VALID�TON <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS VOUR PERMIT <br /> 5. GMDING 5 9 5 M s Q � �, O O �"� � <br /> 6. DRAINAGE <br /> 7. ENVIRONMENTAL IMPACT STATEMENL � <br /> B. HEALTHDISTRICT 1'O t1 R RECEIPT a <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY � <br /> . 71-1.AiJK YOU <br />