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'1 <br /> `,�� `'��;;`oF �'ONSTRUCTION <br /> everett PERMIT pERMIT NO. 11063 <br /> CITY HALL 259�87A5 <br /> evERErr.wn sezo� ❑ COMBINATIpN ❑ BUILDING �tMECHANICAL ❑ PLUMBING <br /> O�YNFN MhILA0�RE55 CRY ZIP PHON[ ( <br /> Charles Thurman 1101 Walnut Everett 96201 259-1200 <br /> ARClIItECi OR OESiGNER MAI�AODRE55 �ItY IIP PuOVE <br /> GEHERAI�UNTPFCtOR AIAIL ApDRE55 CRV iJP PMONE IiCENS[r <br /> IdECMANICALCONTRPCiOF MFILAD�PE55 QTY ZIP PHONE UCENSE� <br /> Same <br /> _ PLU1dBINGCONiRnCfOR 6�AiLnODRE55 CIiY ZIP PNONE UCENS[• � <br /> CL1550F WOPK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑R[PAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAWAiION OF IVORK <br /> S <br /> ['ESCnIBE wOAK <br /> 7nstall wood stove <br /> raorosEo usE eF euno�r+c <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP� <br /> iecn�oescaianoNOFPaoPenrvisHowoeimvonnrr.�o�Fouacori=_s� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �er etoc�_or TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A P[RMIT DOES NOi <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PFRFORMANCE OF CONSTRUCTION. <br /> �oo�ooaess scr�ntuHi eF couran�roa oa auna zeo nc_tir oarc <br /> 1101 Wa3-rcat GQ � �,u,�, ��,i�^ X ����e—.-�,9/2 7/8 2 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OH ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILET� P.Ifi COND.UflITS—H R EA. <br /> BATHTU� �EFRIGERATIOII UNITS—HP.EA <br /> Ll.VAiORV(WASH BASIN� BOILERS—H P EA. <br /> SHOWGR GAS PIRED A C.UNITS—TONNAGE EA <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEIdS—B iL. M EA. <br /> DISNIVASHER IVALL HEATERS—B T.U. M <br /> LAUNDRY TRAV UNIT HEATERS—8.7'.U. M <br /> CLOTHES\'MSHER EVAPORATIVE COOLERS <br /> WATER HEATER CIOTH[S DRYERS <br /> URINAL V[NTILATION FAN <br /> DRINY,ING FOUNTAIIJ RANG[HOOD <br /> FLOOR DRAIN AIR NANDLIN�UMT— C F.M. <br /> VACUUM BREAKERS STOVE WOOCZ � <br /> FOOF DRAINS—PAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> $INN(SERVICE—BA�7.ETC� <br /> SUB TOTAL SI1B TOTAL S 7 S O <br /> PERMIT S PEHMIT S <br /> TOTALFEE S TO7AL FEE S <br /> SIDE YARD SFTBACK STREET SETIIACK �7EAH YARD S[T�ACK PLAN CHECK NUM�[R PLAN CHLCK FEE <br /> F[E RECEIPT NO <br /> USE ZONE lOT AHEA VACANi SITE <br /> I�YES i;NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP N0.OP DWELLING UNITS <br /> BUILDING S <br /> SIZE OF�LDG. NO.OF STORIES MA%.OCG LOAD <br /> PLUMBING <br /> FIRE ZONE BASEM1IENT FIRE SPflINKLERS <br /> fi[OUIflED MECHANIC4L 1] 5� <br /> '�.IYES I;NO <br /> �� APPflOVALS BY DATE OTHER — J <br /> 1. ENVIRONMENTAL CMECK LIST PENAITY U B C. <br /> SEC.303(a) <br /> L BWLDMGPLANS — <br /> 3. FIP,E HYDRANT <br /> TOTAL 1 7 S 0 <br /> 4. FIRE PROTECTION SYSTEM PERMIT VALI�ATION <br /> WHEN PROPERIY VALIDATED�IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING o ^ � � � O I �.� O ^_ M � <br /> 6. DRAINAGE � v L(Q <br /> 7. E�NIRONMENTAL IMPACT STATEMENT �7 <br /> B. HEALTH DISTRICT � <br /> APPLICATION ACC.BV PLANS CNECKED BV APPR.FOR ISSUANGE BY YO� R R EC E I PT �� <br /> TNANK YQ U <br /> . o - <br /> , <br /> ADDRE55 FILE ' '� : � � � $Z <br />