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it I Gi' <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />PERMIT <br />❑ COMBINATION ® BUILDING ❑ MECHANICAL <br />PERMIT NO. 06687 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP 353�NO <br />Olga Walters 308 Morgan Road 98203 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP ^HONE <br />GENERAL CONTRACTOR MAIL AUDRESS CITY - ZIP PHONE LICENSE <br />Everett Builders 5GO6 Evergreen Way 98203 353-7161 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />EV ER EB 301PH <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑NEW GADDITION ❑ALTERATION L$D(EPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />$ 1,933.00 <br />Pmmnnaition re -roof <br />PROPOSED USE OF BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DESCR PTION OF PHOPERTY (SHOW BELOW OR ATTACH FOURCCPIES) <br />SS Beverly Hills Div. 5 <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT_—BLOCK. <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTR�UCTION OR T RFORMANCE OF CONSTRUCTION. <br />SIGNAT FVp CONTRACT OR AUTN /ZED AGENT DATE <br />- <br />9/14/79 <br />JOB ADDRESS <br />308 Morgan Road <br />PLUMBING <br />MEC ANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY (V.ASH BASIN <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />SHOWER <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B iU. M EA. <br />DISHWASHER <br />WALL HEATERS —BT.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATED <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />FLOOD DRAIN <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />MEI AL FIREPLACE 8 CHIMNEY <br />_ <br />SINK (SERVICE — BAR. ETC.) <br />SUBTOTAL <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />TOTAL FEE S <br />TOTAL <br />FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$1933.00 <br />20 <br />00 <br />SIZE OF BLDG. <br />N0. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />DYES ONO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />20 <br />100 <br />3, FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />S. GRADING <br />6. DRAINAGE <br />Tl <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />YG.0 R RE.CEiPT c <br />TiANK YO'U <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE 4 �i <br />