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f1leC1`�'`r"'„ ONSTRUCTIaN <br /> C�,Y OF � _ <br /> ever�ttt PE�n•�'� PERMIT N0. 10440 <br /> .,iTY HALL 259�B7a5 <br /> ev_nerr.wn sezoi ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OIYI:FR MAIL AUDRE55 CitY <br /> [4illiam D. Carpenter 6004 Manor Place Z ��� <br /> 98201 <br /> 4N^NITECT OR DESIGNEq MAIL qODRL55 ��Tp <br /> Zif' PNO�E <br /> GENERAL CONBiALiOR 1,IAq ADDRE55 CITY <br /> Damage Repair Services Box 2045 Z'" P��cN= ucer,se. <br /> Everett 98203 337-4222 <br /> MECHFNICAICCNTfiACiOR AIA'IFDORESS CITV ZIP PII�NE IICEN5E1 <br /> PWMBINGCONTR/GTOR MAItAODR[SS CITY ±iP PMC9E UCENSE� <br /> ClA:S OF 1VORK <br /> ❑NEW ,�ADDITION ❑ALTERATION xXfREPAIR ❑�EMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAIUATION OF WORK <br /> 5 5 � ���.�� <br /> DESCHiBE VfORN <br /> repair fire damage <br /> P�oroseo use oF omioirvc <br /> Single Family Residence I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> i�cn�oeswiPnoHOFrnoaEnrrisnoweE�owor+nrtna�FouRcoriesi PIICATION AND KNOW THC £AME TO BE TfiUE AND CORRECT. <br /> Countr Club Addi tion ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HI5 <br /> �o� 3 ALOCK—oF Y TYPE OF WORK WILL BE COMPLIED VJITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRAN7ING OF A ?ERMIT DOES NOT <br /> PRESUtitE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRE55 -- SiGNA`E 01 C �PACiOR OR nUTMORIZED nGENi �AiE <br /> 6004 hfanor Place " G : , <br /> � ,_ y <br /> X /, . � �G�L .'L-tC-i.ft � � � -,.+" -- <br /> PLUMBING MECHANICAL ;� <br /> � NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILETI AIR COND.UNIU-H.P.EA. <br /> BATHTU� pEFRIGERATION UNITS-H.P.EA <br /> LAVATORY�N'ASH BASIN� UOILERS--H.P.EA. <br /> SMOWER �AS FIRED A.C.UNIT9-TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS-B.T.0 M EA. <br /> _ DISHIVASMER V✓ALL HEATERS-B.T,U. �,� <br /> LAUNDRY TRAY UNIT HEATERS-�.T.U. �� <br /> CIOTNES WASNER EVAPORATIVECOOLERS <br /> WATER NEATER CIOTHES DRYEPS <br /> URINAL V[NTILATION FAN <br /> DRINKING FOUNTAIN RARGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- GF.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS-RAINLEADEflS �tETAL P:REPLACE 8 CHIMNEY <br /> SINK ISEFVICE-BAR.EiCI <br /> SUBTO7AL <br /> — SUB TOTAL 5 <br /> PERMIT S — <br /> PERMIT = <br /> TOTAL FEE S TO7ALFEE S <br /> SIDE YARD SETBACK STHEEi SLTBNCK REAR VARD SETOACK PLAN CHECK NUM�ER P�AN CHECK FEE <br /> FE[ RECEIPT NO <br /> USE ZONE LOT AREA VACANT SITE <br /> i_1VE5 ltNO FEES YALUATICN FEE <br /> TYPe OF CONSi. OCCUPANCY GROUP NO.Of DWELIING UNITS <br /> 512[OF BLDG. NO.OF STORI[5 MA% OCC. LOAD BULLDING S S �OOO. S O S O <br /> PWM�ING <br /> FIRE ZONE GASEMENT FIRE SPRINKIERS - <br /> �7EOUIRED MECHANICAL <br /> '. 1vES I1N0 <br /> APPROVALS BY OATE OTHER <br /> L ENVIRONMENTAL CHECK LIST <br /> PENALiV U 0 C <br /> 2. BUILDING PIANS SEC.303 p�) <br /> 3. FIRE HVDRANT TOTAL 5 O S 0 <br /> a. FIRE PROTECTION SVSTEM PERMIi VALIOATION <br /> 5. GRADING WH:N PI70PERLY VALIDATED�1N THIS SPqCI)^HIOSC 1'OUF�P�i1�11To.r ^ O � <br /> G. ORAINAGE � + a � � � u <br /> 7. ENVIRONMENTALIMPACTSTATEMENT ' � �` J <br /> B. HEALTH DISTRICT Y�u P ��C E�� <br /> APPLICATION ACC.BY PLANS CHECKED UV APPR.FOP ISSUANCE 9Y ) <br /> ��1:7A1V1 YC� <br /> � 1, ��e82 <br /> no�rzess r-i�E <br />