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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8245 <br />EVERETT, WA 99201 <br />CONSTRUCTION <br />ram_ <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />evere" <br />,,e <br />OWNER MAIL ADDRESS L11' w1UNL <br />Scott M. JTi 3431 Oakes <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Natural Gas Equipment 1611 East Grand <br />m <br />1 <br />z <br />C <br />ig <br />CJl m <br />00 <br />M <br />CD <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT <br />❑ COMBINATION <br />[]BUILDING []PLUMBING []MECHANICAL <br />CLASS OF WORK <br />❑ NEW ❑ADDITION [I ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />S <br />❑DEMOLISH []FENCE ❑SIGN ❑SWIMMING Pool. <br />DESCRIBE WORK <br />1 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />— <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />1 <br />I <br />J03 ADDRESS <br />3431 Oakes <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />$ <br />— <br />I <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />2 <br />DISH WASHERS <br />I <br />— <br />FAC. BUILT FIREPLACE R CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />I <br />FLOOR DRAINS <br />1 <br />GAS. SYSTEM: NO OP OUTLETS <br />KITCHEN SINKS & DISP. <br />_ <br />1 <br />SUB TOTAL S <br />Z 1 00 <br />BAR SINKS <br />I <br />PERMIT $ <br />ROOF DRAINS - RAIN LEADERS <br />1 <br />TOTAL FEE $ <br />I00 <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TI/IS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />4/6/79 <br />xU <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />I <br />WATER HEATERS -ELECTRIC <br />1 <br />WASH BASINS <br />1 <br />LAUNDRY TRAYS <br />SUB TOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIG NATUREOFC TRACTOROR <br />AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREETSETOACK REAR <br />YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />UNITS <br />OF DWELLING <br />I <br />BUILDING <br />S <br />I <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES MAX. <br />OCC. LOAD <br />PLUMBING <br />I <br />FIRE ZONE <br />BASEMENT FIRESPRINKLERS <br />REQUIRED <br />❑YES []NO <br />MECHANICAL <br />5 100 <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENALTY <br />SEC. 303(a) <br />I <br />TOTAL <br />100 <br />II <br />PERMIT VALIDATION I <br />W IIL N PRUI'I. I31 v VAUD MEO (IN THIS SPACE) THIS IS YOUR Pf RMIT <br />YOUR RECEDE, <br />THANK YO14D'D <br />CD <br />.1 <br />wa .; 9 + <br />