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`''�`�".r�"`.,' � � CONSTRUCTIC�I � <br />everett PER�JIIT PERMIT NO. 155H2 <br />CITY HALL 259�87d5 <br />EVERETT,WA98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILAD�RE55 QTY 21P PHONE <br />Jack O. Anderson Hughs Road Arlinaton 98223 <br />AR-C,IIITECT OR UFSIGNER MAIL ApOHE55 CITY ZIP PHONE <br />GENERAL GONiPACTOR MAIL ADDRE55 CITY ZIP PNONE LICENSE � <br />Plan Formativn 6822 211th Place N.E. Arlington 98223 439-3609 <br />MEGHANIGAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE �ICENSE 11 <br />PLANFV*280QE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE IICENSE I <br />O NEW ❑ ADDITION ❑ ALTERATION XBREPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />f 1900.00 <br />construct n�w <br />single family residence <br />22-24 496 <br />�oT_eiocn _ov <br />Rainier <br />Capitol Hill 2nd <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />W ATER CLOSET (TOI LEn <br />BATHTUB <br />LAVA70RY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FIOOR ORAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADE <br />SINK 1SERVICE — BAR, ETC.) <br />S118 TOTAL <br />PEPMIT <br />TOTAL FEE <br />SIDE YARD SETBACK STPEE7 SETBA� <br />USE ZONE LOT AfiEA <br />TYPE OF CONST. OCCUPANCY G <br />SIZE OF BLDG. NO. OF STOFIE <br />FIRE ZONE BASF.MENT <br />APPROVALS <br />t. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HVDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMEPIT <br />8. HEAL7H OISTRICT <br />APPLICATION ACC. BY PLANS CHEC <br />FEE <br />5 <br />S <br />S <br />::YES �.�.NO <br />APPR. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PqOVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING �ONSTRUCTION Ofl THE <br />PERFQRMANCE OF CONSTRUCTION. <br />SIGNql�jilE OF CONTRACTQR OR�y.UjHORIZED AGENT [)ATE <br />NO. TVPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIFiED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WF I 1. HEATEFS — B.T.U. M <br />UN��T r1EATERS — B.T.U. M <br />EVAFORATIVE COOLERS <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOO� <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOO� <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL f <br />PERMIT f <br />TOTALFEE S <br />( NUMBEF PLAN CHECK FEE <br />FEE RECEIPT N0. <br />FEES VALUATION FEE <br />BUILDING <br />LOAD <br />PLUMBING <br />KLERS MECHANICAL <br />10 <br />DATE OTHER <br />DAB <br />s 1900. <br />F�� 1 1 <br />PENALTY SFC 3G3 (al <br />TOTAL 31 00 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THI6 SPAG�I7HI9'i151YQU� PIfRMI�_ , 7; <br />�{ 1 J•t .DUJ UU I <br />r 1 • : <br />��. ��_. �. I.�t.�i_�1�� . � <br />',11. 1��.: �� <br />ADDRESS FIIE <br />I 5 �'�T u 7 <br />