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� <br /> �,ieei���Y�oF �'pNSTRUCTION � <br /> everett PERMIT PERMIT NO. ZO563 <br /> CITY HALL 259�8745 <br /> EVERETT,WA sezo� ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PL'JMBING <br /> t OWNER IAAILAOORE55 piV ZIP PMONE <br /> I Alwyn Pouliot 2905 Panaview Blvd. Everett 98203 353-1456 <br /> AFGMREGTOPDESIGNER MAILApORESS CIiY ZIP PHONE <br /> � <br /> GENEP.ALCONiRnCiOR MAItACDflESS CITV ZIP PNONE LICENSE� <br /> Same <br /> MECHFNiCALCANTPRCTOR MAILAD�RE55 CITY ZIP PHONE LIGENSEI <br /> � PWMBINGCONiRACTOR MAILAODRESS dTY 21P PMONE IiCENSE! <br /> LlASS OF 4VORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION �f{ENCE ❑SIGN ❑GARAGE <br /> 1'ALUATION OF WOFH <br /> S 480.00 <br /> oEscaioe woaK <br /> construct 6' Cedar Fence <br /> PFOPOSED q5E OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> �Ec;ALOESGAIPtIONOFPflOPERTY�SNOW�ELOWORATTACHFOURCAPIES� PLICATION AND KNOW THE SAME TO BE THUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �ot o�ocK_oF 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 /> SIGNAT E OF GONiFACTOR 0 - AGENi � OATE <br /> JOB r10DRE55 5/17/8 2 <br /> 2905 Panaview Blvd. X � <br /> PLUINBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOS�T ROILET) AIR COND.UNITS—H.P.EA. <br /> J BATHTUD REFRIGERA110N UNITS—H.P.EA <br /> LAVATORV ryJASH BASIN) BOILERS—H.P.EA. <br /> SHUWER GAS FIRED A C.UNITS—TONNAGE EA. <br /> KITCHEN SINK&DISP. FORCED AIR SYSTEMS—B T.U. M EA. <br /> 71SHWASHER WALL HEATERS—�T.U. A1 <br /> IAUNDRY TRAY UNIT HEATLRS—0 TL. �� <br /> CLOTHES WASHER EVAPORATIVE COOLEfiS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> ORINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VA"UUM BRF7�KERS STOVE <br /> ROOF DRAINS—RAWLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SIKK�SERVICE—BAR,ETC.) <br /> SUB70TAL SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL�EE S 70TALFEE S <br /> SiDE YARD SEiBACK STREET SE1ftACK �EAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE FECEIPT N0. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> NPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING � 480. 00 10 00 <br /> SIZE OF BLDI: N0.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE Bf•.SEMENT FIRE SPqINKLERS <br /> RLOUIRED MECHANICAL <br /> ❑YES I]NO � <br /> I APPROVALS BY DA7E �THEfl — <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.�.C. <br /> SEC.3031a) <br /> 2. BUILDINGPLANS TOTAL 10 00� <br /> 3. FIRE HYDRAN7 <br /> 4. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> •� WHEN PROPERLY VAUDATED pN THIS SPACE)THIS IS YOUR PERMIT <br /> L. 6 ORAMAGE 2 6 5 5 <br /> =0 I A.00 — cD <br /> 7. ENVIRONMENTALIMPACTSTATEMEN7 � <br /> B. HEALTH DISTRICT YO U R REC El PT � <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY T H AN K Y O U � � <br /> ' 18 �Y81 <br /> ADDRESS FILE , ��. _ . - <br />