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the [rCIT <br />CITY <br />OF <br />F ^ONSTRUCTION <br />F <br />everett PERMIT PERMITNO. 1.1888 <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 ❑ COMBINATION K8 BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Revival Chapel <br />2717 Harrison <br />Everett <br />98201 <br />659-7718 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P <br />PHONE <br />LICENSE 4 <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE II <br />SI <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE <br />ILnnc yr Yv inn <br />NEW El ADDITION ❑ ALTERATION 0 REPAIR ❑DEMOLITION ❑FENCE ❑SIGN 0 WOOD STOVFJFIREPLACE INSERT <br />PROPOSED USE OF BUILDING <br />;ingle Family RifXXY 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 CONTRACTOR OR AUT RIZED AGENT DATE <br />X 4/18/83 <br />LEGAL DescRlPnoN OF PROPERTr lsrww BELow oR ATTACH FouR coPlEsl <br />2?1�—N'22&OCK 6440F Rucker' s 2nd A <br />JOB ADDRLSS <br />2723 Harrison <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 8 DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />RY TRAY <br />UNIT HEATERS - B.T.U. M <br />ES WASHER <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />HEATER <br />I <br />VENTILATION FAN <br />NG FOUNTAIN <br />RANGE HOOD <br />DRAINAIR <br />HANDLING UNIT - C.F.M. <br />M BREAKERS <br />STOVE -WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />i <br />SUB TOTAL f <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />S <br />TOTAL FEE S. <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />fEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OC- LOAD <br />PLUMBING <br />FIREZONEBASEMENT <br />FIRE SPRINKLERS <br />NOAPPROVALS <br />MECHANICALREQUIREDYES <br />MA <br />OTHER1. <br />BY <br />DATE <br />ENVIRONMENTAL CHECK LIST <br />PENALTY <br />2. BUILDING PLANS <br />TOTAL <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION ��J� <br />WHEN PROPERLY VALIDATED IIN T J E) THIS 9 YbRi IEfYAIi ;S^ <br />0 0 U U <br />/'� ._ <br />YOUR U R RECEIPT <br />' <br />5. GRADING <br />6. DRAINAGE <br />7, ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />I!' <br />ADDRESS FILE <br />