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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION a BUILDING • MECHANICAL <br />• PLUMBING <br />OWNER MAIL ADDRESS ZIP PHONE <br />Reggie Nelson 2526 51st Street S.W. 98203 355-6766 <br />m <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />z <br />C <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT CLASS OF WORK <br />❑COMBINATION <br />❑BUILDING []PLUMBING ❑MECHANICAL ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK ..(E{E���� <br />$ 5,800 00 ❑DEMOLISH ❑FENCE ❑SIGN ; WIMMING POOL <br />DESCRIBE WORK <br />construct swimming pool <br />PROPOSED USE <br />single family pool <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />LOUR 5�IFJ4LOCK 3 OF Queen Anne <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />1 <br />BOILERS-H.P. EA. <br />400 <br />FORCED AIR SYSTEMS—B.T.U. MEA. <br />1 <br />JOB ADDRESS <br />4626 Greely <br />SPACE & WALL HEATERS — B.T.U. <br />UNIT HEATERS—B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />T— <br />V ENTI CATION FAN <br />RANGEHOOD <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT— C.F.M. <br />BATH TUBS <br />S <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />-- I <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />I <br />FLOOP OR <br />I <br />SUBTOTAL $ <br />41 <br />KITCHEN SINKS & UISP. <br />PERMIT $ <br />TOTAL FEE S I <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />Check #40 10/18/77 <br />X <br />RAR SINKS <br />ROOF D00 <br />RAINS —RAIN LEADERS <br />SHOWER BATHS <br />SERVICE SINKS <br />SUMPS —SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS — ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />Drain O S1 esewer <br />1 <br />SUB TOTAL <br />PERMIT <br />s <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIGNATURE OF CONT RACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />6 <br />STREET SETBACK <br />20 <br />REAR YARD SETBACK <br />6 <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />6000 <br />VACANT SITE <br />DYES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />DWELLING <br />UNITS <br />I <br />BUILDING <br />$ 5,800. 00 <br />36 1 00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />5 j 00 <br />FIRE ZONE <br />BASEMENT <br />FI RE SP R INK LE RS <br />REQUIRED <br />DYES ONO <br />MECHANICAL <br />17 00 <br />I <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENALTY <br />SEC. 303(a) <br />i <br />1 <br />TOTAL <br />_ <br />48 VO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (ICJ i IJIS SPAC IIISYVUR PERMIT <br />1 �Law <br />�Jv <br />YOU R RECEIPTr-O <br />, THANK YOU <br />APPLICATIONACCEPTLOUY: <br />PLANS DIECSL) BY: <br />APPROVED FOR ISSUANCE BY. <br />K.C.eb <br />ADDRESS FILE 1) 9 nf'T 77 <br />