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„ <br /> , _ _ -- <br /> - ---� <br /> , rhe EveCrRyee�n �- ^O N ST R U CT I O N <br /> everett PERMIT PERMIT NO. 1�165 <br /> CITV HALL 2598715 <br /> EVERETT,WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> ' OWNER MFIL ADDRESS CITY IIP PMONE <br /> ' W W. BENITO 3507 NORTON Fvoratt W/1 9A2p1 252-929� <br /> � ARCHITECT OR DESIONER MAII ADDRE55 CITY 21P PMON�— <br /> OENER�L CONTN�CTOR MAIL AOORESS QTV 21P PHONE LICENSE� <br /> OWL BUILDERS <br /> MECHANICAL CONTRRCTOR MPIL ADDRE55 CITY ZIP PHONE UCENSE I <br /> PLUMBING WNTfl�CTOR MAIL ADDR[SS CITV ZIP PHONE UCENSE� <br /> ` CLA55 OF WORK <br /> I ❑NEW ❑ ADDITION ❑ ALTERATION X�REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN O WOOD STOVUFIREPLACE INSER7 <br /> VAIU�TION OF WORK ' <br /> f 2 388.91 <br /> UESCHIBE WORK <br /> Reroof - cedar shakes <br /> PROPOSED USE OF Bl11LDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCHIPTION OF PROPERTY�SHOW BELOW Ofl ATTACH fOUR COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �.or3b4 BLOCK_OF Frida �S First Addn GOVERNItJG THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> i PERMIT DOES NOT PRESUMETO 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�UDRE55 SIGNATURE OF CONTFAGTOR O AIIT AGENT DATE <br /> � 3507 Norton X • w <br /> I PLUMBINO MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM PEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILEn AIR COND.UNITS — H.P. EA. <br /> I BATHTUB REFRIGERATION UNITS— H.P. EA. <br /> '�, LAVATORYIWASH BASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS—70NNAGE EA. <br /> � KITCHENSINK6 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WA�ER HEATER CLO7HES DRVERS <br /> URINAL �ENTILATION FAN <br /> � DRINKING FOUNTAIN RANGE HOOD <br /> � FLOOR DRAIN AIF HANDLING UNIT— C.F.M. <br /> , VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 6 CHIMNEY <br /> ' SINK(SERVICE— BAR, ETC.) FIREPLACE INSERT <br /> HEA7 PUMP <br /> SUB TOTAI f SUB TOTAL f <br /> PERMIT S PEHMIT S <br /> TOTALFEE S TOTAL FEE S <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBEFi PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> [�.YES i;tl0 FEES VALUATION FEE <br /> TYPE OF CONS7. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> I SI2E OF BLDG. NO.OF STORIES MAX.OCQ LOA� BUILDING S Z,388.91 38 SO <br /> PLUM8ING <br /> FIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> �YES ❑NO <br /> APPNOYALS BY UATE OTHER <br /> ' 1.ENVIRONMENTAL CHECK UST PENALTY U.B.C. <br /> SEC.;03(a) <br /> . 2.BUILDINGPLANS 38 5� <br /> 3.FIRE HVDRANT TOTAL <br /> <.FIRE PROTECTION SYSTEM PENMIT VIILIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN THISB�A6CT)TIi�S1SOYC�IF�PEp�1T__L(� <br /> / � � b � �1 J <br /> . 6.DRAINAGE � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � <br /> 8.HEALTH DISTRICT <br /> APPLICATION ACC.8Y PLANS CHECKED BY APPR.FOR ISSUANCE BY YO U R �R E C E I PT <br /> THA�K YOU <br /> - 3 ,u� 8 3 <br /> ADDRE55 FILE <br />