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. . . <br /> _ r�E,�;�n , �, CC�tS�TRUCI�'ItJN H <br /> cirv oF . , <br /> everett . � PERMIfi�, PEp�,� No. 07574 . <br /> CITV HALL 2598715 � ; � - <br /> EVERETT.WA 88201 ❑ COMIBINATION. �BUILDING ❑ MFCMANICAL ❑ PLUMaINO . . • - � <br /> OWNEH MAIL E55 QTY ZIV p�qryE ' .. � <br /> Robert 0. Solem 2118 Maple 98201 259-45c�1 <br /> ARCHrtECTOPOE5IGNER M/JLFDORE55 CITY ZiP PHONE <br /> GENER�LCONTRACTOR MAILADDRE55 CITY ZIP PHONE �ICENSE♦ <br /> Same <br /> MECMANIGI CONTRACTOR M�I�FDDRE55 CITY ZIP %q11E �ICENSE� <br /> P:UMBING CANTRA�TOR MAIL ADDRE55 CITY ZIP PHpNE I�LENSE/ <br /> C1A550F WOFK <br /> ❑NEW ❑ADDITION ❑ALTERATION [�(iEPAIR ❑DEMOLITION ❑�ENCE ❑SIGN ❑GARAGE <br /> VAIURT10N OF WORK <br /> f 2��0�.00 <br /> DESCpIBE WORK <br /> re-roof Shake zemove existing roof <br /> PROPOSED USE OF BWLDING <br /> }FIGBYXttltXYi[TX Residential I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGA�DESGRIPiiONOFPpOPEpTy(SHOWBEIOWORATTI.GHFOl1RCAPiE51 PLICATION AND KNOW THE SA.ME TO BE TRUE AND CORRECT. <br /> 23-2� 449 Miley Land Co'a 2nd ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior ioc�_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTPUCTION OR THE PERFORMANCE OF CONSTRUCTION. , <br /> JOB ADORE55 SIGNATURE OF CONTR iOR OR AUiHO IZCU NT ppTE I <br /> 2118 Maple X � 5/12/80 ' <br /> PLUMBINQ MECHANICAL <br /> N0. TYPE OF F�XTUHE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET QOILET) AIR COND.UNITS—H.P.EA. <br /> BATNTUO REFRIGEFATION UNITS—H.P.EA <br /> LAVATORY(WASH BASIN) 601LER5—HP.EA. <br /> SMOWER GAS FlRED AC.UNITS—TONNAGE EA. � <br /> KITCHEN SWK 6 DISP. FORCED AIR SVSTEh1S—B.TL. M EA. <br /> DISHWASNER WALL HEATEFS—B.T.U. M I <br /> LAUNDRV TRAV UNIT HEA?ERS—B.T.U. M <br /> CLOTNES WASHER EVAPpRATNE CAOLERS I <br /> WATER HEATER CIOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR OFAIN AIR HANDLING UNIT— QF.M. <br /> VACUUM BREAKERS SiOVE <br /> ROOF DRAINS—RAINLEADERS tdEiAL FIREPLACE S CHIMNEV <br /> SINK(SERVICE—BAR.ETC.) <br />� SUBTOTAL SUB TOTAL S <br /> PEHMIT S PERMIT S <br />� TOTALFEE S TOTALFEE t <br /> SIDE YARD SETdACK STRE[T S[TBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> fEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> !7VE5 ❑NO FEES VALUATION FEE <br />� TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br />�c BUILDING $ 2�000. 20 00 <br /> ;� SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br />' PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLEI75 <br />' REQUIRED MECHANICAL <br /> r1Y[S ❑NO <br /> APPpOVALS BY DATE OTHER <br /> t. ENVIRONMENTALCMECKl15T <br /> PENALTV U.B.C. <br /> 2. BUILDING PLANS SEC.3031a) <br /> 3. FIRE HYDRANT TOTAL 20 00 <br /> 4. FIRE PROTECiION SYSTEM PEpM1T VALIDATON <br /> WMEN PROPEflLV VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRA�ING <br /> 6. DflAINAGE � � <br /> 7. ENVIRONMENTAL IMPACT STATEMENT �O ' � �,O �A.�� T'����� <br /> 8. HEALTH DISTRICT • � • I` � <br /> APPLICATION ACC.BY PUNS CHECKED BY APPR.FOH ISSUANCE BV , p <br /> YO�l'R RECEIPT <br />�� <br /> ' THANK YOU <br /> ,, <br />�,.,,;, <br />�,� ADDRESS FILE , - _-- _ ��_,uv_an _- -__ __-- <br />