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''"� `'����-��° � �ONSTRUCTIOI`' <br /> everett PERMI'P PERMIT N0. 1�4 � � <br /> CITV NALL 259�8745 <br /> EVERETT,WA 98201 � COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OY:NER <br /> AIAIL ADOPESS GITY iIP PHONE <br /> ROBERT JACODSON 1630 OMkeooqEss Everett WAc98201 252P9788 PHONE <br /> APCMREGT OR OESIGNER <br /> GENERNL CONiNACTOR <br /> M��L Ap�RE55 GITY ZiP PHONE LICENSE� <br /> Same �in ZIP PMONE LIGEIJSE i <br /> MECHANIL6L GONTRACTOR IAAIL AO�RE55 <br /> PLUMBING CONTRACTOR <br /> MAIL AODRE55 LRY 21P PHONE LILENSE� <br /> L1A55 OF WORK <br /> ❑NEW ❑ ADDITION ❑ �LTERATION �REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFlREPLAGE INSE <br /> VAIUATION OF WORK <br /> T5000.Q� <br /> OESCRBE WOPo: <br /> Reroof and siding <br /> PpOPOSE�USE OF OUIL�ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ReSldance APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> IEGA�0E5CRIPi�ONJFPRO?ERTYISNOWBELOWORATTACMFOUNCOPIES� CORRECT. ALL PROVISIONS OF IAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �oT_e�ocK_.oF_ WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES T PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL TV�E PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL L� ATING CONSTRUCTION OR THE <br /> �PERFORM E F C NSTR CTION. <br /> JOB PDOPESS SIGNAiU � ONiRA TOH AUiNO 2EU AGENi �6/1/84 <br /> 1630 Oakes X <br /> PLUMBING A� � <br /> N0. TYPE OF FI%TURE OR 1TEM <br /> FEE NO. � E OF EOUIPMENT FEE _ <br /> WATERCLOSET�TOILEn AIF CO .UNITS - H.P.EA. <br /> REFRIGERATION UNITS- H.P.EA. <br /> BhiHTUB <br /> LAVATORV�WASH BASIN� BOILERS- H.P. EA. <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> SHOWER <br /> KITCHEN SINN 8 DISP. FORCED AIR SYSTEh1S- B.T.U. M EA. _ <br /> - WALL HEATERS- B.T.U. M <br /> DISHWASHER <br /> UNIT MEATERS- B.T.U. M <br /> LAUNDRYTRAY <br /> CLOTHES WASi�ER EVAPORAI IVE COOLERS <br /> CLOTMES DRVERS <br /> WpTER HEATER <br /> URINAL VENT.ILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD � <br /> AIR HANDLING UNIT- C.F.M. j <br /> FLOOR DRAIN �� <br /> VACUUM BREAKERS STOVE-�M1'OOD [*: <br /> ROOF DRAINS- AA�NLEADERS METAL FIREP�ACE d CHIMNEY <br /> SINK(SERVICE- BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> H 1- <br /> y r. <br /> H �- <br /> SUB 70TAL S � � <br /> SUB 70TAL S O <br /> 5 PERMIT S C � <br /> PERMI� [T1 <br /> TOTAL FEE 5 <br /> TOTALFEE S P�AN CHECK FEE y <br /> SIDE YAPD SETBACK STREET SEiBACK REAR YARD SETBACK PLAN CHECK NUMBER O C <br /> FEE RECEIP7 NO. F� <br /> USE ZONE LOT AFEA VACANT SI7E FEES VALUATION FEE � F� <br /> . �.YES � -NO �Q �� <br /> TYPE OF CONST. OCCUPANGY GROb� NO.OF DWELUNG UNITS � `' <br /> BUILDING 5 5 000. 50 50 � i- <br /> SIZE OF BLDG. N0.OF STORIES MA%.OCC. LOAD pLUMBING ~ <br /> Ot <br /> "� r' <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS h�ECHANICAL _ � r�� <br /> REOUIRED <br /> .�.YES -NO OTHER � � • <br /> APPFOVALS BY DA7E �-y <br /> U.B.C. b t <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY SEC.703(a) C , <br /> 2.BUILOING�LANS TO�AL 5� 5� <br /> 3.FIREMYDRANT � ; <br /> a.FIRE PROTECTION SYSTEM PERMIi VALIOATION <br /> WHEN PROPERLY VALIDATED QN THIS SPAQFj�THIS I�+Y�p�REQ)��T __�, <br /> S.GRADING ` � ' `J 1 <br /> 6.DRAINAGE � <br /> I 7.ENVIRONMENTALIMPACTSTATEMENT , r � <br /> B.HEALTHDISTRICT � ' I I�T <br /> j APPLICATION ACC. BY PIANS CHECKED BY APPR. FOR ISSUANCE BY . . .. �� <br /> � :�DDRISS 19L[ <br />