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� <br /> �he Erergreen CO' ,ST R U CTI O N � . � <br /> CITY OF <br /> -_ _-- ------_ _ __ ---- P€�MlT- - -----_ _-��►��-e-�-8-,�-�-- <br /> �i�����-- - ----- - --- ...-- <br /> CITY HALL 259�8745 � COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> EVEPE�T,WA 98201 <br /> OWNER MAILR��RE55 CITY ZiP PHON[ <br /> Marcella O' Brien 1928 Oakes Everett 98201 252-9779 <br /> ARCHITELTOROESIGNER M/ILAODPE55 QTV 2iP PNONE <br /> GENERALCANTHFCTOfl <br /> MAIL AD�RE55 CITY ZIP PNONE LICENSE 1 <br /> Same <br /> MCCNANICRLCONTRAGTOR MAILADDRE55 CiTY 21P PMONE UCENSEI <br /> PLUMBING fANTRACTOF NAIL ADDRE55 C1iV 21P PHONE UGENSE� <br /> C1A55 OF WORK <br /> ❑NEW ❑ADDITION I�ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GARAGE <br /> �PLUAiION OF WORH <br /> b <br /> OESCRIBE WORK <br /> install metal fireplace <br /> PR01'OSED USE OF BWLDING <br /> single family residence I HEREBY CERTIFl�THAT I HAVE READ AlJD E�AMINED THIS AP- <br /> LEGALDESCRIPTIONOf PROPEHLYISHOW BELOW ORATT/CHFOURCOPiES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AN�ORDINANCES GOVERNING THIS <br /> �or eiocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SFECIFIED <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 LOCA� LAW REGUL.ATING <br /> CONSTRUCTION OR THE PERFOAMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONiRAGTOR OR AUTNON12E0 AGENI �ATE <br /> JOBADf]RESS X ` � � _y�� 2/3/81 <br /> 1928 Oakes <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM PEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(iOILET) AIR WND.UNITS—HP.EA. <br /> HEFRIGERATION UNITS—H.P.EA i <br /> �ATHiUB <br /> LAVATORY(WASH BASIN) �OILLRS—H.P.EA. — <br /> GAS FlRED AC.UNITS—TONNAGE EA. <br /> SHOWER <br /> K17CHEN SINK&DISP. FORCED AIR SYSTEMS—B.T.U. M EA <br /> Wi.LLHEATERS—BTU. h� <br /> DISHWASHER M <br /> UNIT HEATEHS—B.T.U. <br /> LAUNDRY7RAY <br /> [VAPORATNECOOLERS <br /> CLOTHES WASHER CLOTHES DRYERS <br /> WATER HEATER <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> NR HANDLING UNIT— GF.M. <br /> FLOOR DRAIN <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS MC-TAL FIREPIACE 8 CHIMNEV <br /> SINK(SERVICE—BAR.ETC! <br /> SUBTOTAL S 4 0 <br /> SUBTOTAL pENMIT 5 3 00 <br /> PERMIT = <br /> TOTAL FEE S TOTAL FEE F 7 S O <br /> SIDE VARD SETBACK STRFET SETBACK REAR YARD SC-TBALK PLAN CHECK NUM�ER PLAN CHECK FEE <br /> F[E RECEIPT NO. <br /> USE ZONE LOT AREA LYES T�S1N� FEES VALUATION FEE <br /> TYPE OF fANST. OCCUPANCY GROUP NO.OF DWELLING UhITS <br /> BUILDING $ <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIREZONE BASEMENT qEOUIRED KLEFS MECHANICAL 7 �� <br /> ❑YES I7N0 �7, <br /> pPPpOVALS <br /> BY DATE O7HER <br /> 1. ENVIRONMENTAL CHECK LIST PENAITY U.B C. <br /> SEC.303(a) <br /> 2. BUILDING PLANS <br /> TOTAL 7 S 0 <br /> 3. FIPE HYDRANT <br /> d. FIRE PROTECTION SYS7EM PERMIT VALIDATION <br /> WHEN PROPERIY VALIDATED(M 7HIS SPACE)THI515 YOUR PERMIT <br /> S. GRADING 3U2 � � 007. 5Q - � <br /> 6. DHAINAGE <br /> � <br /> 7. ENVIRONMENTALIMPACTSTATEMENT n � - <br /> B. HEALTH DISTRICT 1� � f� � �`���1�T O <br /> APPLICATION ACC.9Y PLANS CNECKED BY APPP.FOR ISSUANCE BY • • �•i • <br /> . 1 ' �� <br /> V.C. <br /> - !!. i�9 u � <br /> ADDRESS FILE � <br />