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die Errrxreen � �O N ST R U CT I O I� � <br /> , ciTv oF � <br /> everet� PERMIT PERMIT NO. � <br /> CITY HALL 259�8745 <br /> EVERETT,WA 98201 ❑ COMBINATION �I BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MAII A�DRE55 CITY 21P PHONE <br /> Linnie Erdle 1008 Maple Everett 98201 259-1424 <br /> ARCHRECT OP DESIGNEfl MAIL AODRESS CITY ZiP PMONE <br /> iENEflAL CONTRACTOR MAIL ApDRESS CITY ZIP PMONE LICENSE� <br /> Self <br /> MECHANICALGONTRACTOR MAI�A�DRESS CITY ZIP PHONE LICENSE/ <br /> PLUMBING CONTRRCTOF MAIL AD�RESS CITY 21P PMONE UCENSE M <br /> CLASS OF WORK <br /> ❑ NEW �O ADDITION ❑ ALTERATION ❑REPAIR ❑ OEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> 5 1�5�0.0� <br /> DESLfl16E WORK <br /> C3TpOTt <br /> PROPoSED USE OF BUIL�ING <br /> Parking APPLICATION ANDTKNOW THERSAME TOEBE TIRUE AND <br /> I EGRL DESCIiIPTION OF PR10�P�RTY�SHOW BELOW OP ATTACH FOUR COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �0�0"32 a�ocK-$=or i� �� GOVERNING THIS TYP� OF WORK WILL BE COMPLIED WITH <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 STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOR NCE OF CONSTRUCTION. <br /> JOB ADDRESS SIGNATU �CONTRACTOR OR AU 2E0 GENT DATE <br /> 1008 Maple Everett, lVA 98201 � <br /> PLUMBING MECffANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILEn AIR COND. UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> LAVATOPY�WASM BASIN) 001LEFS— H.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHENSINKADISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER K'ALL HEATERS— B.T.U. M <br /> LAUNDRV TRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHEfi EVAPORATIVE COOLERS <br /> WATER HEATEP CLOTHES DRYERS <br /> URINAL �ENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HO00 <br /> FLOOFi DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS S70VE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE — BAR,ETC.) FIFEPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL S SUB TOTAL S <br /> PEHMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE S <br /> SIDE VARD SETBACK STREETSETBACK REAF YARDSETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 5 Z 85/15067 FEElb.25 RECEIPT NO. <br /> USE ZONE LOT AREA VACAN7 SITE <br /> R-Z 9000 S ft ��:YES X;NO FEES VALUATION FEE <br /> TYPE OF CONST. OGCUPANCY GROUP NO.OF DWELLING UNITS <br /> V - N h1 O BUILDING s1,500.00 25 0 <br /> SIZE OF BLDG. N0.OF STORIES MA%. OCC. LOAO — <br /> ZO X Z2 1 N A P�UMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> YES XNO <br /> APPqOVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLANS ZS O <br /> 3.FIRENYDRANT TOTAL <br /> <.FIRE PROTECTION SVS7EM PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS Yt7UR PERMIT_ _ r}�• <br /> _ � <br /> 6.DRAINAGE <br /> � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � <br /> 8.HEALTH DISTRICT , , ; � <br /> APPLICA710N ACC. BY PLANS CHECKED BY APPR.FOR�SSUANCE BY <br /> STG JEF LC I <br /> �a��i�aes; ri�[ <br />