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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT. WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION To BUILDING • MECHANICAL P PLUMbING <br />i <br />OWNER MAIL ADDRESS ZIP PHONE <br />T. Clyde Pitcher Jr. 1312 Maryland 96203 252-2700 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />Ogden-Dykeman 3216 Wetmore 259-3161 <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PRONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />� <br />7 <br />C <br />W <br />C) 7J <br />, <br />C' <br />C <br />PERMIT <br />❑COMBINATION <br />❑BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION []ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />S 9,500 00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />roof over swim pool <br />PROPOSED USE <br />Single Family <br />MECHANICAL <br />TYPE <br />OF ENERGY <br />❑GAS ❑EIEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LGT BLOCK —OF ----- <br />- _ - <br />JOB ADDRESS <br />1312 Maryland <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS—H.P. EA. S <br />1 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />FORCED AIR SYSTEMS-B.T.V. MEA. <br />1 <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />1 <br />EVAPORATIVE COOLERS <br />PLUMBING <br />- - - <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />CLOTHES DRYERS <br />I <br />--r <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OF OUTLETS <br />FLOOR DRAINS <br />I <br />SUB TOTAL S <br />1 <br />KITCHEN SINKS & DISP. <br />I <br />BAR SINKS <br />I <br />PERMIT S <br />ROOF DRAINS - RAIN LEADERS <br />1 <br />TOTAL FEE S <br />I <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />- 12/9/77 <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER HEATERS - ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />PERMIT S <br />TOTAL FEE <br />WATER <br />SERVICE SIZE_ BLDG. SUPPLY <br />SIZE <br />SIRE CO NTRACTORORA H. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />77/754 <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />26.00 26652 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLIN <br />UNITS <br />BUILDING <br />S 9,500.00 <br />52 100 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />I <br />I <br />I <br />1 <br />52 i00 <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REQUIRED <br />❑YES ONO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />PENALTY <br />SEC. 303(a) <br />_ <br />TOTAL <br />— <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IITJIjSjPACEjTdA�j, RP_=HM111 <br />YOUR RECEIPfo <br />THANK YOU ,`0 <br />Q I <br />NmLICATIUIIACCEPILUPY. <br />PLANSCIIECRIUaY. <br />APPPUVIDEU1165UANCCPV <br />K.C.eb <br />ADDRESS FILE I <br />I I -.9 ftT, 77 .. _.. <br />