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f <br /> `,,``'�T;`oF �ONSTRUCTION - <br /> e�erett PERMIT pERMIT NO. 10793 <br /> CITY HALL 259�8745 <br /> EVERETT.WA 9azo� ❑ COMBINATIO:V ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> UWNER MAI�ADORE55 CiTY ZIP PIIONh <br /> Mark Simard 1932 Oakes Everett 98201 <br /> nRCMTFCT OR DESIGNER MAI�ADDPE55 CIiY ZIP PHONE `. <br /> GENEFALCONiRFCTOR 1,1qi�A00PE5S QTY ZIP PHONE LICENSE/ <br /> MECMANiCALCONTRACTOR MAILqODRE55 QT'I ZIP PMONE IICENSE� <br /> r Natural Gas Equipment 1611 East Grand Everett 98201 258-2441 <br /> PW!�BINGCONiRACTOR AIA!iAppP.E55 CIiY ZIP PHON2 �IGENSE� <br /> CLASS OF WORN <br /> ❑NEW ❑ADDITION LALTERATION ❑REPAIR L]DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> b <br /> DESCRIpE WOPK <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> IEGAL�E.'.GRIPTIONOFPROPER�V�SNOW BELOWORATTAGNFOURGCPI[5) PLICATION AMD KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS Of- 'AWS AND ORDINANCES GOVERNING THIS <br /> ior BLOC�OF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. iHE GRANTING OF A PERMIT DOES NOT <br /> . PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JO�ADDRE55 SIGNAT REOPCONiRACTORORAViHOR12EDAGENT ONTE <br /> 1932 Oakes X 7/22/82 <br /> PLUMBING MEC ANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAiER CLOSET(TOILET) AIR COND.UNITS—HP.EA. <br /> BATHTUB REFPIGERATION UNITS—N.P.EA <br /> IAVATORY ryJASN BASIN� BOIL[HS—H.P.EA. <br /> SHOWER GAS FIPEC AL.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SVSTEMS—B.T.U. M EA. <br /> DISHWASHER Y/ALL HEAiERS—B T.U. M <br /> LAUNDqV TRAY UNIT HEATERS—�.T.U. M <br /> CLOTHGS WASHER El'APOPATIVE COOLERS <br /> WATER N;ATER CLOTHES DRYE iS <br /> URINAL V[NTILATION FAN <br /> DRMKING FOUNTHIN RANGE HOOD <br /> FLOUR DRAIN AI(i HANDLING UNIT— C,f.A1. <br /> VpCUUId t{qEPNERS STOVE <br /> ROOF DRnINS—RAINLE4DERS METAL FINEPLACE 8 CHIMNEV <br /> SINK pER'/IC[—BAR.ETC.) <br /> SUB TOTAL SUB TOTAL 5 2 00 <br /> PERMIT S PEHMIT 5 <br /> TOTAL FEE f TOTAL FEE S 5 <br /> SIDE VARD SETBACK STREET SETOACK REAR YARD SETBACK PLAN CHECK NUMBER P�AN CHECK FEL <br /> FEE qECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> I7YES [7N0 FEES VALUATIGN FEE <br /> TYPE OF CONST. IX)CUPANCY GROUP N0.OF OWELLING UNITS <br /> DUILDING � <br /> SIZE Of�LDG. N0.OF$70RIE5 MA%.00C.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLGRS <br /> REOUIRGD AIECHANICAL S OO <br /> I IIYES ❑NO — <br /> � APPROVALS BY DATE OTHER <br /> 1. FNVIRONMENTALCHECKLIST <br /> —_ PENALTY U.BC. <br /> 2. BUILDINGPLANS SEC.303(a) <br /> 3. FIREHVDfiANT TOTAL S 00 <br /> 4. FIRE PROTECTION SYSTEN PEHMIT VALIDATION <br /> WHEN PROPERLY VALIDATEO(IN THIS SPACE)Tf11515 YOUR PERMI7 <br /> 5. GRAOING � <br /> 6. �RAINAGE 5 3 S� �s�O Q S, 8�O •�� (� i <br /> 7. ENVIRONMENTAL IMPACT STATEMENT ' � . . , � <br /> 8. HEAL7H DISTRICT ' � ` � ' O <br /> APPLICATION ACC.BV PLANS CHECKED BY APPR.FOR ISSUANCE BY YO'f1�R R EC E I PT � <br /> 7HAN1� YOU <br /> . � i � <br /> ADDRESS FIL_E ' ` k'� `� 82 <br />