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r — — <br /> `"`.£,�T�e�F r �ONSTRUCTIO�: <br /> everett PERMIT PeRMir No. 12245 <br /> CITY HALL 259�87d5 � <br /> EVERETT,WA90201 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> OWNEfl MAILAODRE55 CITV ZIP PHONE <br /> KEN BOSMAN 2927 PANAVIEW EVERETT 96203 '� <br /> ARCMITECT OR OESIGNER MAIL ADORESS GITY Z�P PMONE <br /> GENERALCONTRACTOF MAILAD�RE55 CITY 21P PNONE LILENSEM <br /> MECHANICAL CONTRAGTOfl MAIL AD�RE55 CITY 21P PNONE LILENSE M <br /> RICHARDSON & RICHARDSON 29200 S E JUDD EAGLE CREEK � OR 97022 (503) 637-6275 <br /> PLLIMBING CONTRAGTOR MAIL AOORESS CITY 21P PHONE IICENSE� <br /> � GLR55 OF WORK <br /> �NEW O ADDITION � ALTERATION ❑REPAIR � DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VnLUATION OF WORN <br /> f <br /> DESCHIBE WORK <br /> INSTALL SOLAR SYSTEM <br /> PROPOSED USE OF Bl11LDING <br /> I HEREBY CERTIFY THAT I IiAVE READ AND [XAMINED T <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL�ESCRIPTIONOFPROPERTY�SMOWBELOWORATTACMFOUFCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT__BLOCK_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY 70 VIOLATE <br /> OR CAN�EL—'fH€-P_F� S OF ANY OTHER STATE OR <br /> LO AL '�RE NG CONSTRUCTION OR THE <br /> p A,NCE � STRUCTION. <br /> JOB 10DRE55 1 N /. R AUTHORI2ED AGENT 7/2]��B 3 <br /> 2927 PANAVIEW X ?r <br /> PLUMBING M A A� <br /> N0. TYPE OF FIXTURE OR ITEM1 ., FEE TYPE OF EOUIPMENT FEE <br /> WATEFCLOSET(TOILEn � AfR COND.UNITS- H.P.EA. <br /> BA7HTUB t REFRIGERA710N UNITS- H.P.EA. <br /> - ,._.l-_.__ <br /> LAVATORY�WASHBASIN) ' BOILERS- H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS-70NNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS- B.T.U. M EA. <br /> DISHWASHER WALL HEATERS- B.7.U. M1 <br /> LAUNDRY TRAY UNI7 HEATERS- B.T.U. M <br /> CLOTHES WASHER EVAPORA7IVE COOLER3 <br /> WATER MEATER CLOTHES DRYERS <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 DRAINS- RAIN�EADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE- BAR,ETG) FIREPLACE INSERT <br /> HEAT PUMP <br /> 1 THERMAL SYPHON 4 5 <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PENMIT S 1 <br /> TOTAL FEE S TOTAL FEE S 14 S O <br /> SIDEYARD SETBACK STREET SETB�CK REAR YARO SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SI7E FEES VALUATION FEE <br /> f:YES '�_�NO <br /> TYPE OF CONST, OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING $ <br /> SIZE OF BL�G. NO.OF S70RIE5 MAX.OGC.LOAD <br /> PLUMBING <br /> FIREZONE BASEMENT REOUSRED KLERS MECHANICAL <br /> I �,�.YES ;:NO <br /> - APPROVALS BY DA7E OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY U.B.G. <br /> SEC.303(a) <br /> 2.BUILDING PLANS TOTAL 14 S O <br /> 3.FIHE HYDRANT <br /> 4.FIRE PROTECTION SYSTEM PENMIT VALIDATION <br /> 5.GRADING WHENPROPERLYVALIDATED(INTHIS�SPIGEITHISfS�QJl�PA�1�T.��� � <br /> L 70U0 a � <br /> 6.DRAINAGE (V I <br /> 7.ENVIRONMENTALIMPACTSTATEMENT <br /> B.HEALTHDISTPICT `fOUR RECEIPT„� <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BV �I-inN K YO V <br /> dab dab <br /> 2z �. s3 <br /> ADDRESS FILE <br />