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the EveCIT OF -- C"STRUCTION <br />everett PERMIT PERMIT NO.08246 <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 ❑ COMBINATION ®C BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONL <br />Voth Bros. Inc. <br />1310 116th N.E. Bellevue <br />98004 <br />453-9414 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />ERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE 1 <br />%N <br />ame <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE IF <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />V LAJJ V. YYVnn <br />❑NEW ❑ADDITION ❑ALTERATION CIREPAIR )LgDEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />uauvaia.LL oauyic ivau�a aZ <br />PROPOSED USE OF BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DESCRIPTION OF PROPERTY (SFHOW BELOW OR ATTACH FOUR COPIES) <br />10 753 Everett Land <br />BLOCK-_GF <br />Co. 1st <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT . <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 />SIGNATUR CONTRACTOR OR.OUT ED AGENT DATE <br />JOB ADDRESS <br />3219 Pine Street <br />X ?' 9/9/80 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA, <br />BATHTLIB <br />REFRIGERATION UNITS — H.P, EA <br />LAVATORY ASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B T.U. M <br />IAUNDRY 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 />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADER_S <br />METAL FIREPLACES CHIMNEY <br />SINK (SERVICE — BAR. ETC.' <br />SUB TOTAL <br />SUB TOTAL ! <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />TOTAL <br />FEE <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 />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />00 <br />00 <br />S1ZE OF BLDG. <br />NO.OF STORIES <br />MAX. OOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />SPRINKLERS <br />RED <br />MECHANICAL <br />OYES <br />ONO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK. LIST <br />— <br />PENALTY <br />U B C SEC. 303(a) <br />2. BUILDING PLANS <br />�� <br />TOTAL <br />00 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />7 5 2 5 S 0 0 0.0 <br />N <br />5. GRADING <br />6. DRAINAGE <br />TEMENT <br />7. ENVIRONMqBYPLANS <br />D r� p <br />Ti ^' J R R � C E I 92 <br />-( 1 N. \N K Y C. U <br />B. HEALTH DI <br />APPLICATION <br />CHECKED BY <br />APPR. FOR ISSUANCE BY <br />0 SFP x U <br />ADDRESS FILE <br />