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the Evergreen C-)NSTRUCTION <br />everett PERMIT PERMIT 140. 09083 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 ❑ COMBINATION @KBUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Louis M. Larson 7810 Grant Drive Everett 98203 353-1398 <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 MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK J�L.. <br />WWEW ❑ADDITION ❑ALTERATION ❑REPAIR El DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />S 5 <br />Construct single family Garage <br />PROPOSED USE OF BUILDING <br />Two Car garage and shop <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X 7/ ✓ c{CL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />18 2 Beverly Park <br />LOT BLOCK. —OF <br />JOB ADDRESS <br />7810 Grant Drive <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 />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUE TOTAL <br />SUBTOTAL 3 <br />PERMIT <br />S <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />6 T <br />STREET SETBACK <br />2 0 L <br />REAR YARD SETBACK <br />2 0 T <br />PLAN CHECK NUMBER <br />81/9083 <br />PLAN CHECK <br />FEE <br />32.83 <br />FEE <br />RECEIPT NO. <br />S 5 <br />USE ZONE <br />R—I <br />LOT AREA <br />12720 SQ. FT. <br />VACANT SITE <br />OYESXXNO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST, <br />V-N <br />OCCUPANCY GROUP <br />M-I <br />NO. OF DWELLING UNITS <br />BUILDING <br />$5000. 00 <br />50 <br />50 <br />SIZE OF BLDG. <br />! O L X2 4 L <br />NO. OF STORIES <br />I <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />]YES YNO <br />MECHA;..CAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1, ENV'; IONMENTAL CHECI, LIST <br />PENALTY <br />ED C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />5 0 <br />S O <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />% 1 C 9 I� O• O -- ty <br />« <br />T <br />E. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />