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theG�•erqrpen � �ONSTRUCTIO� • <br /> ��;v0� � <br /> everett PERMIT PERMIT NO. 15370 <br /> CITV HALL 259�87a5 <br /> EVERETT,WA 98201 ❑ COMBINATIOH I� BUILDING ❑ MECHANICAL ❑ PLUM8ING <br /> OWNER MAIL ADDRE55 GITY ZIP PHONE <br /> John Medema 3130 �187CSf�0f7C Wetmore Everett 98206 <br /> RRLnITEGi OR DESIGNER MAiL AD�AESS pTY ZIP PMONE <br /> GENERRLLONTR�GTOR MAILADDRE55 CRY 21V PHONE 4GENSE� <br /> Fuller a Son P.O. Box 1134 Everett 98206 259-6978 <br /> MECN�NIG�IGONTRRGiOR MAILApDRE55 GRY ZIP VHONE � LICENSEI <br /> PLUMBING GONTRRGTOR MAIL AODRE55 CITY ZIP PMONE LICENSE/ <br /> CLA55 OF WORK <br /> ❑NEW ❑ ADDITION O AL7ERATION ❑REPAIR Q�EMOLITION ❑ FENCE ❑ SIGN C WOOD STOVFJFIREPLACE INSERi <br /> V�LUATtON OF WORK <br /> e <br /> DESCFIBE WOAN <br /> Demolish Single Family REsidence <br /> PROPOSFD USE OF BVIL�ING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW TME SAME TO BE TRUE AND <br /> LEGRL DESCRIPiION OF PROPEPTY�SHOW BELOW OR AiTACH FOUR COPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �oT24 e�ocK 739 oF Everett SII![![Land Co. 's lst GOVERNING TMIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHEA SPECIFIED HEREIN OR NOT.THE GHANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OH CANCEL THE PROVISIONS OF ANY QTHEfi STPTE OR <br /> LOCAL LAW R[GULATING CONSTRUCTION OR THE <br /> PERFORMA E OF CONSTRUCTION <br /> JOB ADDRESS SIGNRTUR O RaCTOR OR 2ED DATE <br /> �� 1814 Pacific X n� 9/3/85 <br /> PLUMSIN6 MECMANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSEryTOILEn AiR COND.UNITS— H.P.EA. _ <br /> BATHTUB REFRIGERATION UNITS— H.P. EA. <br /> LAVATORY(WASN BASINI �OIIERS — H.R EA. <br /> SHOtNER GAS FIRED A.C.UNITS —TONNAGE ER. <br /> KITCHEN SINK 6 DISP. FORCED AIR SVSTLMS— B.T.U. M EA. <br /> DISHWASMER WALL MEATER£— B.T.U. M <br /> LAUNDRY TPAV UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE CUOLERS <br /> WATER H[ATER GLOTMES DRVERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIi— C.F.M. _ <br /> VACUUM BREAKEHS STOVE —W�OD <br /> ROOF DRAINS— RAINIEADERS METAL FIREPLACE 6 CHIMNEY <br /> SINK�SERVICE — BAR, ETC.� FIREPLAGE INSERL <br /> HE>T PUMP <br /> SUB TOTAL i SUB TOT11L f v <br /> FERMIT f PERMIT t _ <br /> TOTAL FEE f TOTIIL FEE f <br /> SIDE YARD SETBACK STflEET SETBACK REAR YhRD SETBPCK PLAN CHEGK NUMBEF PLAN CMECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SI7E FEES VALUIITION �EE <br /> VES NO <br /> TVPE OF CONST. OCGUPANGY GROUP NO.OF OWELLING UNITS <br /> BUILDING E 00 00 <br /> SI2E OF BLDG. NO.OF S70RIE5 MA%.OCQ LOAD <br /> PI.UMBING <br /> PIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> YES NO <br /> APPROVALS BY D�TE OfHER <br /> 1.ENVIFONMENTAL CHECK LIST PENALTV U.B C. <br /> SEC.3^31a� <br /> 2.BUILDING PLANS TQT�� OO OO <br /> 3.FIRE HVDRAl1T <br /> 4.FIRE PROTECTION SYS7EM PERMIT VALIDATION �� i f (� f1 (1 �[L --Ot <br /> 5.GRADING WHEN PROPERLY VALIDATED IIN THIS A�F�THIS��IDW�E�R�w� <br /> � <br /> 6.DRAINAGE (�'� <br /> 7.ENVIRONMENTALIMPACTSTATEMENT Vv � � RECEIPT� <br /> 8.HEALTH DISTRICT � �"'� <br /> APPLICAiION RCC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY 't F-� �,�N 1; Y O U <br /> --- — - q s�r 85 <br /> ADDRE55 fILE <br />