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I <br />,he Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT, WA 98201 <br />PERMIT <br />COMBINATION a BUILDING A MECHANICAL a PLUMBING <br />evereti <br />OWNER MAIL ADDRESS ZIP PHONE <br />MICHAEL W. & LINDA L. BROWN 3424 NASSAU ST. EVERETT 98201 259-6398 <br />V <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />3 <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />SELF <br />z <br />C <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />� <br />r_. m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT CLASS <br />❑COMBINATION <br />[]BUILDING ❑PLUMBING []MECHANICAL <br />OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />V NLUATION OF WORK <br />S <br />)$]DEMOLISH []FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />DEMOLISH WOOD SHED <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COME Sb.00K_-OF 11 of 22 Block 828 Plat of Everett, <br />DIV. "HII <br />NO. <br />TYPE EOUE <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 />FORCED AIR SYSTEMS-B.T.U. MEA. <br />I <br />JOB ADDRESS <br />3424 NASSAU ST. EVERETT <br />SPACE & WALL HEATERS - B.T.U. <br />- -' <br />UNIT HEATERS-B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />5 <br />WATER HEATER <br />I <br />CLOTHES WASHER <br />I <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />i <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS------------- <br />�- <br />I 1� <br />FI_')OR DRAINS <br />I <br />SUB TOTAL 5 <br />I <br />KITCHEN SINKS & DISP. <br />I <br />PERMIT 5 <br />TOTAL FEE S I <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 I IME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 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 THIS 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 />X <br />SIGNATUREOFCONT FACTOR DR AUTH.AG"•" DATE <br />PLAN CHECK NUMBER PLAN t'' .LCK FEE <br />FEE RECEIPT NO. <br />BAR SINKS <br />ROOF DRAINS - RAIN LEADEHS <br />SHOWER BATHS <br />I <br />I <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />1 <br />WATER HEATERS - ELECTRIC <br />1 <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />_ <br />I <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />WATER SERVICE SIZE BLDG. SUPPLY SIZE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />USEZONE <br />LOT'AREA <br />VACANTSITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNITS DWELLING <br />BUILDING <br />s <br />1 <br />NO IFEE <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINK LERS <br />REQUIRED <br />❑YES ONO <br />MECHANICAL <br />- <br />OTHER <br />I <br />I <br />SPECIAL CONDITIONS: <br />PENALTY <br />TOTAL <br />SEC. 003(a) <br />I <br />NO IFEE <br />- <br />-- <br />PERMIT VALIDATION <br />WHEN PROPL KEY V ALIDAI ED II�1•j l}I'�S P A C E..j j.jo�R PE RM1= <br />I �EII6j vu YvTm <br />�. <br />YO U RE P Rea I/� T o . <br />• , THANK YOiI <br />API-1 IU110N ACCCPTCD IIY: <br />PLANS CHECKLD BY: <br />APPROVED COO ISSDANCC BY. <br />I <br />ADDRESS FILE - X �01% I6 <br />