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� Iht£vtry¢rten {. <br /> CITYOF �---� -t;O��TRUCTIOr` �� � <br />' everett PERMI� PERMIT N0. 15441 ° <br /> GTY MALl75&B7�5 <br />.. EVERETT,WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBIN(3 <br /> pWqE MAIL ADURE55 CITY ZIP PNONE <br /> Dean B. Van Overbeke 16905 SOth Street S.E. Snohomieh 98290 334-5213 <br />� ARCHITECT OR DESIGNEP M�IL ADDRE55 CITY ZIP PMONE <br /> NEN�LCONTNACTOR MRILADDRESS CITV ZIP PHONF UCENSEI <br /> Van Overbeke Const. VA NO VC 215 PS <br /> MlECN�NIC�L CONTR�GTOfl MAIL AOORE55 GTY 21P PHONE LICEN:,E� <br /> PLUMBING CONTRAGTOR M�IL AOOHE55 GTY ZIP PHONE UCENSE� <br /> GUSS OF WORK <br /> ❑NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR �DEMOLI710N ❑ FENCE CI SI,N ❑ WOOD STOVFIFIREPLACE INSERT <br /> V�LU�TION OF WORK <br /> f <br /> DESCRIBE W�1RK <br /> Demoliah Single Fami;y Residence <br /> PRDPOSED IISE OF BUILDING <br /> Demolish Sin le Famil REsidence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> g y APPIICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESGRIPTIONOFPROPERTY�SNOWBELOWORATfACHFOURCOPIES) CORRECT. A' L PROVISIONS OF LAWS AND ORDINANCES <br /> ��iS-Z� e�ocK 23 oF Everett "T" GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> — WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERIAIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> — OR CANCEL THE PROVISIONS OF ANY OTHEfl STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORM NCE OF CONSTRUCTION. <br /> JOB�DDRE55 SIGN TUR CONTRA 10R RAUiHORREDAGENT OATE <br /> 1218 Maple X ' <br /> PLUMBINO ME HANIC <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EUUIPMENT FEE <br /> 1YATERCLOSETITOILET) AIR COND UNITS— H.P.EA. <br /> BATHTUB REFRIGER4710N UNITS— H.P.EA. <br /> LAVA70RV(YVASH BASIN) BOILEfiS— H.F. EA. <br /> SHOWER GAS FIRED A.C. UNI7S— TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS — B.T.U. M EA. <br /> �ISMWASHER WALL HEATERS— B.T.U. M <br /> LAUMDRYTRAY UNIT HEATERS— B.T.U. M <br /> CLOTMES WASHER EVAPORATIVE COOLEFiS <br /> WATER MEATER CLOTh�ES DRYEHS <br /> UP�VAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOO[7 <br /> qOOF DRAINS— RAINLEADERS ME7AL FIFiEPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR,ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL f SUB TOTAI f <br /> PENMIT S PERMIT S <br /> TOTAL FEE f TOTAL FEE f <br /> SIpE YAPD SEiBAGK S7FEET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO <br /> USE 20NE LOT AREA VACANT SITE — <br /> I:YES [:NO FEES VALUATION FEE <br /> iVPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING E 00 00 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING <br /> FIRE ZONL BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> :�.YES . !NO <br /> APPHOVALS BY DATE O7HER • <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILDINGPLANS TOTAL 00 00 <br /> 3.FIRE HV�RqNT <br /> 4.FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> 5.GRADING WHEN PROPERLV VALIDATED(IN THyS,$P4A�E)THI�I�YRIj�t f�f�.11T � <br /> � U UU UU <br /> 6.DRAINAGE � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT �('� <br /> 8.HEAL7H DISTRICT �j�._:)�� � ��L'l.L I i�� � <br /> APPLICA?ION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY /� 1 <br /> �1 1 ,I� �'.I�. ��l- l� <br /> 2 � ���� s 5 , <br /> ADDRESS FILE <br />