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"1 <br /> ,," ``"`r"�„ ; CONSTRUCTIO' ' <br /> _�,, �F <br /> everett PERMIT PERMIT NO. �-27HO <br /> CITV NALL 259�8745 <br /> EVERETT.WA90201 � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWHER IAAIL ADDRESS GRV ZIP PMONE <br /> KffNNETH IYICKER 1819 DfAPLE EV�RETT IVA 98201 252-2998 _ � <br /> AFCHITECT OF OESIGNER MAIL ApDRE55 LITY ZIP PMONE <br /> GENERAL CONTRACTOR MFIL AOOPE55 CITY 21P PMDNE IICENSE� <br /> ENERGY BUILDERS Everett IVA 258-2708 ENERGB199KQ22;-01 <br /> MECNRNICAI LONTRACTOR MAIL ADDRESS GITY 21P PMONE LICENSE� <br /> PLUMpING CONTRAGTOfl MAIL ADORE55 CITY ZIP PHONE LIGENSE� <br /> _ � <br /> ClASS OF WORK <br /> ❑NEW ❑ ADDI110N XXAL7ERATION ❑RF• . ❑ DEMOLITION ❑ FENCE ❑ SIGN � WOOD S70VJFIREPLACE INSERT <br /> VAI UATION OF WORN <br /> y .�5�� . �� <br /> �ESCRIBE WOFK <br /> Carport <br /> PROPoSEO USE OF BUILDING <br /> Storage I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPERTY�SM01Y B_'L01Y OF ATfACM FOUR GOPIES� CORRECT. ALL FROVISIONS OF LAWS AND ORDINANCES <br /> �or�e�ocK�oF Victory Addn GOVERNING THIS TYPE 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 OT�1ER STPTE OR <br /> LOCAL LAW REGULATING CONST CTION OR THE <br /> PERFORMANCE OF CQNSTR}1CTION. <br /> JOB AU�RESS SIGNqTUF TO O�.A T O�iZE AGENT DFTE <br /> 1819 D1a le X'� � ��� <br /> PLUMBING MEC NICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSETITOILE7) AIH COND.UNIiS — H.P. EA. <br /> BATHTUB REFRIGERATION IINITS— H.P. EA. <br /> LAVATORY�WASHBASIN) BOILERS— H.P. EA. <br /> SHOWER GAS FIRED A.C.lJtlITS—TONNAGE EA. <br /> KITCHEN SINK 8 D�SP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEA7ERS — B.T.U. M <br /> LAUNDRYiRAY UNI7 HEATERS— B.7.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEPS <br /> WA7ER HEA7ER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE MOOD <br /> FLOOR ORAIN AIR HANDLING Ut�1T— C.F.M. <br /> VACUUM BREAKERS STOVE— WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIHEPLACE 8 CHIMNEY <br /> SINK 1SERVICE— BAR,ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL i SUB TO7AL S <br /> PERMIT S PENMIT S <br /> 70TAL FEE - S TOTAL FEE f <br /> SIDE YARD SETBAGK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 5' 20 ' Z� � 83/12780 FEEZ8 � 93 661E7PrNo. <br /> USE ZONE LO7 AREA VACANT SITE <br /> . .VES NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> aui�oirvc 53500. 00 44 50 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.lOAO <br /> PLUMBING <br /> FIREZONE BASEMENT FIRE SPRINKIERS MECHANICAL <br /> '_ REOUIRED � <br /> YES NO <br /> APPHOVALS BY DATE �THER <br /> t.ENVIRONMENTAL CHECK LIS7 PENAL7Y U.B.C. <br /> SEC.30](a) <br /> 2.BUILOING PLANS <br /> TOTAL <br /> 3.FIRE MYDRANT <br /> a.FIRE PROTECTION SYSTEM PEHMI7 VALI�ATION <br /> �_ 5.GRADING WHEN PROPERLV VALIDATED QN THI$�P(�4�THIS�IS�YQU�P�R�A�T � <br /> 7 �� a U i, u <br /> 6.DRAINAGE � <br /> 7.ENVIRONM[N7ALIMPACTSTATEMENT (V <br /> B.HEALTH�ISTRICT , , �_I f; R�.:C E I PT � <br /> APPLICATION ACC.BY PLANS CMECKED BY APPR. FOR ISSUANCE BY ' <br /> . � . .�� �. i�L1U <br /> EB DB I.0 <br /> - (, LE6 8) <br /> no�eess rne <br /> � <br />