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r <br /> �heEvergreen _ ONSTRUCTION . � <br /> CITY OF <br /> everett PERMIT pERMIT NO. 11166 <br /> CITY HALL 259�8745 <br /> EVERETT,WA 98201 ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAILADDRE55 CITY ZIP MONE <br /> AUTHELIA LOIVMAN 1208 Pacific Everett AL9-2540 <br /> ARCM4[CL OR DESIGN[R MFI�ADDPES$ CITY ZIP FHOHE <br /> GENEAAL CONTRACTOR MRq ADDAESS Clrv ]IP MONE LICCNSE I <br /> DEAN PRATT 17530 SID10N RD S�UI{OMISH 98290 568-6279 337 PB <br /> MECHANiC4lCONTRACiOP MAILADDPE55 Gltt ZIP PMONE VCENSF� <br /> FWMBIN�CANiR4CTOF MAILADDRESS GTY ZIP PNONE LiGENS[I . <br /> � ClA55O�WORK <br /> ❑NEW ❑ADDITION ❑ALiERATION I,@REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAIUAiION OP WORK <br /> } S�Q .QQ <br /> DESCPIBE WORN <br /> Repair existing tiaood porch <br /> PRO�'OSEO USC OF BWLDING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS AP- <br /> ic�uocscaienonc=vaerr.aTr�sNoweeiowoanrTnc��Fouacowes PLICATION ANG KNOW THE SAME i0 BE TRUE AND CORRECT. <br /> �LL PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS <br /> �o�zZ�F 3 eiocK�.�bF '� �� TYPE O` WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PPESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSiRUCTION OR THE PERFO MANCE OF CONSTRUCTION. <br /> JOBPDURE55 SiGNAIUHEOF6'ONiRA . F PAUt� niZ - .C�U �ATE <br /> � <br /> X 7 <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF F�XTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(iOIL[T) Aifl COND.UNR$—H P.EA. <br /> BATHIUB REFRIG[RATIOIJ UNITS—HP.EA <br /> LqVATORY(WASH OASIN) BOILERS—���'.EA. <br /> SHOW[R GAS FlRCD AC.UNITS—TONNAGE EA <br /> KITGHEN SINK 8 DISB FGHCED AIR SYSTCMS—B T.U. M EA <br /> DISHWASNER V�ALL H[ATERS—8 T U. M <br /> LPUNDRY TFAV UNIi Hf>TLf�S—B T.0 M <br /> CLOiNES WASHLR EVAPORATNECOOLERS <br /> WAT[R H[l.1ER CLOTHES DRYEfiS <br /> URINAL VENi1LATION FAN <br /> DRINKING FOUNTAIN RANG[ HOOD <br /> F�OOR ORAIN AIR HANDIING�NIT— C P M. <br /> VACUUM BREANERS STWE <br /> ROOF DRAINS—RAINLEADERS M[iAL RREPLACE 8 CHIMNEV <br /> SINK(SERVIL[—BAR.ETC� <br /> SU!TOTAL SUB TOTAL t <br /> PERMIT f PERMIT f <br /> T0Tl1l FEE f TO7AL FEE f <br /> SIDE YARD SEiBACN STREET S[TOACK REAR YARD SETBACK PLAN CHECK NUMDEfi PLAN CHECK FEE <br /> {[E RECEIPf NO. <br /> USE ZONE LOT nREA VACnNT SIT[ FEES VALUR710N FEE <br /> IiYES I7N0 <br /> TYPE OF CANST. OCCU�ANCY GFOUP NO.OF DWELLING UNItS <br /> BUILDING b S�Q .�� 1 �� <br /> SIZ[OF BLDG. NO OF STORI[S MA%.OCC. LOAD <br /> PLUMBING <br /> FIPE ZONE BASENENT p OUIRED KLERS M[CHANICAL <br /> f1YES IlNO -- <br /> APPROVALS !Y DA7E OTHER <br /> L 1. ENVIRONMENTALCHECKLIST PENALTY UBC <br /> SEC.303(a) <br /> 2. BUILDINGPLANS TOTAL ZO OO <br /> 3. FIRE HYDRANT <br /> 4 FlRE PROIECTION SVSTEM PERMIT VALIDATtON <br /> WHEN PROPERLV VAIIDATED QN THIS SPACE)1 MIS IS YOUR PERMIT <br /> 5. GRADING y # �` <br /> 6 DRRINAGE � I S I �O I 1�.V o ��f� � <br /> 7. ENVIRONA'ENTALIMPACT STATEMENT � <br /> B. HEAI.TH DISTRICT <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY YO U R REC E t PT <br /> tNc THANK YOU <br /> ADDRESS FILF. � ? �T g2 <br />