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OwE&awvvj S -Zp-& 7 <br />CITY OF CINSTRUCTION qppp `� <br />everett PERMIT PERMIT NQ: _ 1 8033 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Harlan Heil 4626 Creely Everett, WA 9820 353-1809 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Owner <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑ NEW &l ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S 2,000 <br />DESCRIBE WORK <br />Install retaining wall, concrete. TO BE ALL ON PRIVATE PROPERTY, NOT TO EXCEED �X <br />5 FT HEIGHT <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS O WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />1 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 <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATU OF CO RACTOR. TNO EO AGENT. OR OWNER DATE <br />X 11 <br />LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ of <br />JOB ADDRESS <br />4626 Greely St. <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 />A C -- A: HNDLG UNITS - H P <br />BATHTUB <br />REFRIGERATION UNITS - H P EA <br />LAVATORY (WASH BASIN) <br />BOILERS - B T.0 /H P <br />SHOWER <br />GAS FIRED AC UNITS - BTU <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS - B T U M EA <br />DISHWASHER <br />WALL HEATERS - BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR, ETC) <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />III <br />SUBTOTAL <br />PERMIT <br />$1 <br />PERMIT <br />TOTAL FEE <br />31 <br />1 TOTAL PEE <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />FLAN CHECK NUMBER <br />87/18833 <br />FEE <br />29.25 <br />RECEIPT NO <br />n . <br />90291 <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />p <br />$2,000. <br />45 <br />00 <br />TYPE OF CONST <br />V-N <br />OCCUPANCY GROUP <br />M-1 <br />NO OF DWELLING UNITS <br />0 <br />PLUMBING <br />SIZE OF BLDG <br />F <br />NO OF STORIES <br />NA <br />MAX OCC LOAD <br />NA <br />MECHANICAL <br />FIRE SPRINKLERS REOUIRED ❑ YES [d NO <br />INVESTIGATION FEE <br />Sec. 304(e) <br />STATE BUILDING SURCHARGE <br />3 <br />SO <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />Be <br />APPR FOR ISSUANCE BY <br />L.C. <br />OD[lYJFlgf)liENlEfd public <br />works <br />20 <br />1 00 <br />TOTAL <br />68.50 <br />38 <br />PERMIT VALIDATION <br />RETAINING WALL ON PRIVATE PROPERTY ONLY. WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />C '3 <br />C17 <br />Ca <br />CO <br />a -- <br />ADDRESS FILE <br />