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dieEcrr�;r��en � p�STRUCTlO� • <br /> r.itv oF � � <br /> everett PERMIT PERMIT NO. �5902 <br /> CITY HAI.�255�87a5 <br /> EVERET7,WA98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �}j PLUMBING <br /> OWNER MAIL AOOPt55 CITY ZIP PHONE <br /> John F. Staudt 2105 Monroe Everett 98203 <br /> FRGHITECT OR DEPoGNER MAIL AOORE55 CITY 21P PHONE �- <br /> GENERALGONTRACTOR MAILADDRE55 dTY 21P PMONE UGENSEII <br /> MECMANICAL CONTPACTOR MAIL�ODRE55 CITY 21P PHONE LICENSE• <br /> �LUMBING CONTRACTOR MML AODRE55 CITY 21P PHONE LIGENSE N <br /> Same __ <br /> CL.:S OF W0:!K <br /> O NEW ❑ ADDIiION ❑ ALTERATION ❑REPAiR O OEMOLITION ❑ FENCE ❑ SIGN C W000 STOVFJFIREPLACE INSERT <br /> VA_UATION OF WOPK <br /> t <br /> DESCRIBE WORN <br /> replace water pipes <br /> PROPOSED USE OF 6UILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> lEWL0E5CRIPfIONOFPROPERTY�5H0Y�BELOWORATTACMF0UIICOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 26-27-28 26 Pii�ehurst Div. B GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT_9LOCK_OF <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> — OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFO MA E 0 CON T UGTION. <br /> J08 ADDRESS SIGNATU Of' OR OR U RiLED A � DATE <br /> 2105 Monroe Street X � 1/6/86 <br /> PLUMBING M CNANICAL , <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILE71 AIR CON�.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITI.HEN SINK 6 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRV TRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASMER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> UPINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— QF.M. <br /> VACUUM BREAKERS STUVC—WOOD <br /> ROOF DRAINS— RAINLEADERS ME7AL FIREPLACE 8 CHIMNEY <br /> SINK�SERVICE— BAR,ETC.) FIREPLACEINSERT <br /> 1 Water Line 2 00 HEATPUMP <br /> SUB TOTAI i 2 00 SUB TOTAL S <br /> PERMIT S PENMIT S <br /> TOTAL FEE S TOTALFEE S <br /> SIDE YARD SETBACK STREC-T SETBAGK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> F9E RECEIPT N0. <br /> USE ZONE LOT AREA VACANi SITE <br /> �.:YES �.:NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING UN�TS <br /> BUIL�ING 5 <br /> SIZE OF BLDG. NO.OF SiORIES MA%.OCQ LOAD <br /> PLUMBING S 00 <br /> FIREZONE BASEMENT FIRESPRINKLERS MEGHANICAL <br /> FiEOUIRE� <br /> YES I NO <br /> APPROVALS BY DATE aTHER <br /> 7. ENVIPONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILOING PLANS <br /> 3.FIREHYDRANT TOTAL S 00 <br /> 4.FIREPROTECTIONSYSTEM WHEN' PROPERLY�ALIDATED�1NTHIS��j���TNIS191YOUR�ERMR (\� <br /> 5.GRADING <br /> � <br /> 6.DRAINAGE <br /> 7.ENVIRONMENTALIMPACTSTATEMENT _ - r.��� �^ '� � �� <br /> . i: 11 <br /> 8.HEALTH DISTRICT `� . !� ��. I\�� r-�' <br /> APPL�CATION ACC. BY PLANS CHECKEU BY APPR.FOR ISSUANCE BY '.j j j; Y C' �J <br /> _ t, �t„� S 6 <br /> ADDREaS FIL[ <br />