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-w . . � � —r � � <br /> the£veCrgYee�n -- C�`NSTRUCTION ' '���� ' <br /> everett PERMIT PERMIT NO. OH39O � <br /> CITY HALL 259�8745 <br /> EVERETf.WA 98201 ❑ COMBINATION C� BUILDING ❑ MECHANICAL ❑ PIUMBING <br /> OWNER MAILAD�RE55 dtt ZIP PMONE <br /> Kenneth Ward 2029 Maple 252-6451 <br /> ARCHITECT OR DESIGNER MPIL ADDPE55 pTV ZIP PHONC <br /> GENERALCONTRACTOR MAILAUDPESS CITY 21P PHONE LICENSEI <br /> H & G Glass Co. 6502 Evergreen Way Everett 98203 353-8484 � <br /> 1AECHANICAL CANTRRGTOR MAIL ADDRE55 GTY IIP PHONE UGENSE 1 <br /> 223-01-40936 <br /> PWMBINGGONTRACTOR MFILP��RESS CITY 21P PHONE LICENSE� <br /> CUSSOF WORK <br /> GNEW ❑AO�ITION ❑AL7ERA710N 7(]jREPAIR ODEMOLITION ❑FENCE ❑SIGN ❑GARAGE � <br /> VALVAiION OF WORK <br /> f 3500. 00 <br /> DESCPIBE WORN . . " - � ' ' <br /> re-side single family reaidence <br /> PROPOSED USE OF AUILDING ' <br /> single family residence I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP• <br /> �ecn�oescniarioNorrrroaea�+isHowse�owoannncHFouRcoaiEs� - PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 19-20 12 Read Land Co' s lst ALL P:�OVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ioT a�a;�oF y TYPE OF WORK WILI BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THF GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTriORITY TO VIOLATE OR CANCEL THE PRO• <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> 5'GNATURE OF GONiRACTOR OR RUTHOPIZ D AGENT DAiE <br /> JOB ADDNESS l 0/7/8 O <br /> 2029 Maple Street X � LL� <br /> PLUMBINO MECHANICAI <br /> �O. TYPE OF FIl(T�1RE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> N'ATER CLOSET(TOiLF:r AIR CAND.UNITS—H.P.EA. <br /> &4THTUB REFRIGERATION UNITS—H.P.EA <br /> L^VATORY(WAS i f ASIN) BOILERS—H.P.EA. � <br /> SHOWEn^ GAS FIFED A.C.UNITS—70NNAGE EA. <br /> KITCHEN SINK 6 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHFii WA�L MEATERS--B.T.U. M <br /> LAUNDR"TRAY UNIT HEATERS—B.T.U. M <br /> CLOTF+cS WASHER EVAPoRA7IVE COOLERS <br /> WA�eR HEATER CLOTHES DRYERS I <br /> URINAL VEN71LA710N FAN • <br /> DRINKING FOUNTAIN NANGE HOOD <br /> fLOOR DRAIN A�R HANDLING UNIT— C.P.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE—BAR,ETC.) <br /> SUBTOTAL SJBTOTAL S <br /> PERMIT i PE�iM1T f <br /> TOTAL FEE f T0Tl1l FEE t <br /> SIDE VARD SETBACK STR[ET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PIAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACAN7 SITE <br /> ❑VES C7N0 FEES VALUATION FEE <br /> TYPE OF CONS7. OCCUPANCY GROUP NO.OF DwELLING UNITS �' <br /> SI2E OF BLDG. NO.OF STORIES MA%.OCC.LOAD BUILDING E 3 5 0 0. 4 4 S O ' <br /> PLUMBING <br /> FIRE 20NE BASEMENT qE0i,5RED KLERS MECMANICAL <br /> ❑YES ❑NO <br /> APPROVALS BY DATE OTi1ER � <br /> 1. ENVIRONMENTALCHECKLISI pLNALTY U.B.C. <br /> SEC.303(a) <br /> 2. BUILDING PLANS <br /> ioi�� 44 50 • � <br /> 3. FIRE HYDRANT <br /> A. FIRE PROTEC710N SYSTEM PERMIT VALIDIITION <br /> WHEN PROPERLV VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING 8 S I O $ O 9 �. 5 V =+-�+� <br /> 6. �RAINAGE <br /> 7. ENVIRONMENTAL IMPAC7 STATEMENT M I <br /> � <br /> 9. HEALTH OISTRICT <br /> APPUCATION ACC.BY PU1NS CHECKED BY APPH.FOR ISSUANCE BV �'�'� �� Q R ti�..[I PT� <br /> �hl^ NK YOU , <br />