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die Llrrtrrri� ;� 0 N ST R U CT I O � � <br /> everett � pE�� eT PERMIT NO. 1549�. <br /> CITY HALL 259�8745 <br /> EVEi7ET7,WA 98201 � COMBINATION G�( BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNEH I,tAILA�ORE55 CITY ZIP PMONE <br /> JACK A. JOHNSEN 2628 PANAVIE41 BLVD EVERETT 41A 98203 355-5228 <br /> ARGMITECT OR DESIGNER MAIL ADORESS CIfY ZIP PHONE <br /> GENERAL GONTflAGiOR MAIL AODRESS CITV ZIP PN�NE UCENSE� <br /> Same <br /> MEGMANICAI CONTqACTOR MAIL ADDRE55 CRY ZIP PNONE IICENSE x <br /> PWMBING CONTRACTOR MAIL AOORE55 CITY 21P PNONE LICENSE x <br /> CLA55 OF WOi1K <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION �REPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S 5��.�0 <br /> OESCRIBE WORK <br /> Repair deck <br /> PROPOSED USE OF BUILOING <br /> Residence I HEREBY CEFTIFY THAT I HAVC READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPERTY�SMOW pELOW OR ATfAGM FOUR COPIES� CORRECT. ALL PROVISIUNS OF LAWS AND ORDINANCES <br /> ioT 44 BLOCK_OF Va112 Vi2W 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 /> PERFOA ANCE OF CO RUCTION. <br /> JOB AOOFE55 SIGNAT E O CONT i� OR A iH RIZED AGENT DATE <br /> 2628 PANAVIEW DLVD 9�2��85 <br /> PLUMBING MECH ICAL � <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET�TOILEn AIF COND.UNITS— M.P.EA. <br /> BA7HTUB REFRIGERA710N UNITS— H.P. EA. <br /> LAVATORV�WASN BASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS —70NNAGE EA. <br /> KI7i,HEN SINK 8�ISP. FORCED AIR SVSTEMS— B.T.U. M EA. <br /> DIStIWASHER WALL HEATERS— B.7.U. M <br /> LAUNORY TRAY UNIT HEATEPS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES ORYEf75 <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANOLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE —WOOD <br /> ROOF ORAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR,ETC.) FIREPLACEINSERT <br /> HEAT PUMP <br /> SUB TOTAI S SUBTOTAL S <br /> PERMIT S PERMI7 S <br /> 707AL FEE S TOTAL FEE S <br /> SIDE YARD SETdACK STREET SEiOACK REAR VARD SE78ACK PLAN CHECK Nl1MBER PLAN CHECK FEE <br /> 3 Z� 't FEE RECEIPT N0. <br /> USE ZONE LOT APEA VACANT,SITE <br /> - .YES ��.NO FEES VALUATION FEF <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING $ SOO.00 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOAD <br /> PLUMBING <br /> FIREZONE DASEMENT FIRESPRINKLERS MECMANICAL <br /> REOUIRED <br /> YES NO <br /> APPROVALS BY OATE OTHER <br /> 1. ENVIRONMENTALCHECK UST PENALTY U.B.C. <br /> SEC.307 1a� <br /> 2.BULL�ING PLANS <br /> 3.FIRE HYOFiANT 70TAL �O OO <br /> 4.FIRE PROTeCTION SYSTEM PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED QN T1���S�BM� �S�O�R�ERMIT � <br /> 6.DflAINAGE *May extend into side to withi'h�a2 f" �' <br /> LENVIRONMENTALIMPACTS7ATEMENT property line if deck 15 nu higher thdfl '.'� <br /> B.HEALTH�ISTRICT 42" and has no roof covering,. <br /> APPLICA710N ACC. BY PLANS CHECKEO BY APPR. FOR ISSUANCE BY � �� ��-��� r I;"I <br /> $9 �C <br /> .�. �l �1' �� <br /> i , .I �;) <br /> ADDR[SS RL[ <br />