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ihe£��eiFreen O N ST R U CT I O� • <br /> e�erett r� � <br /> PERAIIIT PERMIT N0. 1�373 <br /> CITY HALL ::9�B7a5 <br /> EVERETT,WA�8201 �f] COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILADDRE55 CITY ZIP PHONE <br /> ROGER SHERMAN 4905 UELAWARE EVERETT lJFl 98201 252-6452 <br /> AHCHITECT OR DESIGNER MAIl.AODRE55 GTY 21P PHONE <br /> GENEFAL CONTRACTOR MAIL A��RE55 CI7Y ZIP PHONE LICENSE I <br /> THREE LAKES CONSTRUCTION PO DOX 303 SPIOHOMISH WA 98290 568-4310 THREELC201P4 <br /> MELHANICAL CONTRACTOR MAIL APDRESS CI7Y ZIP PHONF LICENSE I <br /> PLUMBI�9 CONTRAGTOR MAIL A�DRE55 CITV ZIP FMONE LICENSE/ <br /> CLASS OF WORK <br /> ❑NEW ❑ AODITION ❑ ALTERATION �REPAIR O DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREP:ACE INSERT <br /> VALUATION OF WORK <br /> : 13,500. <br /> OESCHIBE WOPK <br /> Chip Rehab _ <br /> PROPOSED USE OF BUILDING <br /> Rental I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TAUE AND <br /> LEGAL DESCRIPTION OF PROPERTY�SHOW BELOW OR ATTACM FOUA COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 25-�$ 448 Mi nnesota Addn GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �pT_ OCK_OF 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 /> JOB ADDPE55 SIG GONT`P CTO$OR AUTHO ZED AGENT �ATE <br /> 2110 Pine X v� 4 7 86 <br /> PWMBING MECHANICAL <br /> NO. TYPE OF FIXTURE Ofl ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILEn AIR COND.UNITS—H.P. EA. <br /> BATHTUB REFRIGERA710N UNITS— H.P. EA. <br /> LAVA70RY(WASH BASIN) 801LER5— H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS— TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> OISHWASHER WALL HEATEfiS— B.T.U. ti1 <br /> LAUNDRYTtiAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOIERS <br /> WATER HEATER CLOTHES DRYERS _ <br /> URINAL VEN7ILA(ION FAN <br /> DRINKING FOUNTAIN PANGE HOOD <br /> FLOOR DRAIN A�R HANL�LING UNIT— C.F.M. <br /> VACUUM BflEAKERS STOVE—W00� <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SEFiVICE— BAR.ETC.) FIREPLACE INSERT <br /> HEA7 PUMP <br /> SUB TOTAL f SUB TOTAL S <br /> PENMIT S PERMIT S <br /> TO7AL FEE S TOTAL FEE S <br /> SIDE YARD SETBACK STREET SETBACK FEAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> YES ::NO <br /> TYPE OF CON57. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILOING g <br /> SIZE OF BLDG. N0.OF STORIES MA%.OCC.LOAD <br /> PLUMBING Z OO <br /> FIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> �:YES L�.NO <br /> APPROVALS BY DATE �TMER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLANS ,_� TOTAL 106 50 <br /> J.FIREHYDRANT �" <br /> 4.FIRE PHOTECTION SYSTE PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN THIS SPACE THIS 5 O R P T (1' <br /> ,_ ie � � 4, � tl �,.�"� —, . _t <br /> 6.DRAINAGE �=�� � ��+ <br /> `7.ENVIRONMENTALIMPACT TATEMENT (!_� <br /> _ : <br /> ,¢HEALTH.D�STqIGT � �, � . � �� i� <br /> �ApPLICATION ACC. BY j LANS CMECKED BY NPPR. FOR ISSUANCE BY - <br /> c_, �. . . � . . � .� <br /> ' <br /> � " i <br /> � - j .,� ,� �u <br /> ADDRESS hILE <br />