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rde £rerireen � jONSTRUGTIOP ' <br /> everett PERMIT PERMIT N0. 1�g2 � <br /> CI7V HALL 259�B165 <br /> EVERE7T,WA5B201 ❑ COMBINA'fION �X BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNEP MAILADDRE55 GITY ZIP FIiOYC <br /> Rill PFTFRSON F19 PFfKS t1RTVF FVFRFTT WA 9R?03 �F3-3849 <br /> ARCMITEGT OR DESIGNER h1AIL ADORE55 CITY 21P PHONE <br /> GENERAL CONTHAGTOR MAIL AD�RESS G�TY ZIP PNONE IICENS[• <br /> MEGMANICAL CONTPRGTOR MAIL AD�RESS CIiY 21P PMONE LICENSE I <br /> PWMBING COkTRAGTOR MAIL AppRE55 GITV ZIP PMONF LICENSE R <br /> CLA55Of WORK <br /> ❑ NEW ❑ P.DDITIGN XX ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> S 250.�� <br /> DESCRIBE WORN <br /> Install glass door - sliding <br /> PROPOSED USE OF BUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMI�ED THIS <br /> Residence <br /> APPLICAT�ON AND KNOV! THE SAME TO BE TRUE AND <br /> LEGALOESCRIPtIONOFPPOPERTV�5H01Y6EL0\YORATTACMFOURCOPIE51 CORRECT. ALL PROVISIO�VS OF LAWS AND ORDINANCFS <br /> GOVERNING THIS TYPE O�WORK WILL 8E COMPLIED WITH <br /> LOT_BLOCN_OF WHETHER SPECIFIED HEREIN OR NOT.THE GFiANTING 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 /> JOB AD�NESS SIGNATI' OF GONiR O -ORIZE�AGENT y�l��$4 <br /> 519 Pecks Drive X <br /> PLUMBING MECHANICAL _ <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET�701LEn AIR COND.UNI7S— H.P.EA. <br /> �ATHTUB REFRIGERATION UNITS — H.P. EA. <br /> LAVATORY�WASHBASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS—IONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. td EA. <br /> DISHWASHER WALL HEATERS-- B.T.U. M _ <br /> LAUNDRYTHAV UNIT MEATERS— B.T.U. M <br /> CLO7HE5 WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VEtJTILATION FAN <br /> DRINKING FOUNTAIIJ RANGE HO00 <br /> FLOOR DRAIN AIR HANDLING UNIT— QF.M. 2 <br /> VACUUM BREAKERS STOVE —WOOD �c`-- <br /> � <br /> ROOF OPAINS— RAINLEADERS METAL FIREPLACE& CHIMNEY _ f: <br /> ['7 <br /> SINK(SERVICE— BAR, ETC.) FIREPLACE INSERT • <br /> — HEAT Pl1MP <br /> H H <br /> SUB iOTAL S SUBTOTAL S <br /> �3 � <br /> ti � <br /> PERMIT i PERMIT S U7 ^ <br /> TOTAL FEE S TOTAL FEE S p �C, <br /> SIDE YAPD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE �� ( <br /> FEE RECEIPT NO. � <br /> c <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE y € <br /> . .YES :NO 5 ��. <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DK'ELLING UNI7S C7 �' <br /> BUILDING E �D— � ' <br /> SIZE CF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> ri r- <br /> PLUMBING y c� <br /> K <br /> FIHEZONE BASEMENT FIRESPRINKLERS MECHANICAL <br /> REOUIRED � �� <br /> . -VES . NO — � ' <br /> APPROVALS BY DATE OTHER yx F� <br /> 1. ENVIRONMENTAL CHECK UST PENALTY LLB.C. :T7 �,' <br /> SEC.303 Ial <br /> 2.BUILDING PLANS �O OO � �-. <br /> 3.FIRE MYDRANT TOTAL <br /> 4.FIRE PROTECTION SVSTEM PERMI7 VALIDATION � <br /> 5.GRADING WHEN PROPEFLY VALIDATED QN THIS$PAGE�THIS IS YOU�pEF�MIT _�)� ' � � <br /> r � N , . <br /> 6.DPAINAGE � ' � <br /> 7.ENVIRONMENTAL IMPACT STATEMEtJT _� <br /> 8.HEALTM DISTRICT . . � � '•� t—� <br /> APPLICATION ACC.BY PLANS CHECKED BV APPR. FORISSUANCE OV . , � � <br /> i <br /> ,'���.i)i,. ._ . , �.._ <br />