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the ETergreen <br />CITY OF <br />everetf <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />CnNSTRUCTION <br />PERMIT <br />❑ COMBINATION 6t BUILDING ❑ MECHANICAL <br />PERMIT NO. 08252 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Robert D. Wood 2232 Monroe Ave. Everett 98203 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE IT <br />Alpha Contracting <br />5325 SR 92 <br />Z Lake Stevens <br />691-6071 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE E <br />_ AL PH AC 201MW <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />❑NEW ❑ADDITION ❑ALTERATION IN EPAIR ❑DEMOLITION ❑FENCE ❑SIGN CIGARAGE <br />VALUATION OF WORK <br />$ 5,000.00 <br />DESCRIBE WORK <br />Foundation repair <br />PROPOSED USE OF BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AIJO EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />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 />SIGNAF E OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X 9/10/80 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />L21Q-In BLOCK 353E Everett Div. U <br />iVBD�Es'hainier Avenue <br />PLUMBING <br />CHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />I TYPE OF EOUIPMENT FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — Y.P. EA. <br />BATHTUB <br />REFRIGERATION U111TS — H.P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A . UNITS —TONNAGE EA. <br />KITCHEN SINK A DISP, <br />FORCED AIR SYSTEMS — B.T.IJ. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />_ <br />IRANGEHOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C F.M. <br />VACUUM BREAKERS <br />STOVE <br />— <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />SUBTOTAL f <br />PERMIT S <br />1 <br />1 <br />PERMIT $ <br />TOTAL FEE <br />TOTAL <br />FEEIII <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE. <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />15T 000. ll <br />32 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES ❑NO <br />MECHANICAL <br />I— <br />F <br />APPROVALS <br />BY <br />__ _ <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />32 <br />00 <br />d. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />({ <br />] 5 4 6 S 0 j ?. O O L■q <br />N <br />00 <br />Y ,,') U R R E C E I PTo <br />t IANK YOU <br />S. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE 1 0 SEP 80 <br />