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Ow Lt PerCreeN <br />everett 4CONSTRUCTIOI* <br />• <br />CITY HALL 259-8745 PERMIT PERMIT NO. 15343 <br />EVERETT, WA 98201 E] COMB!NATION GiX BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY DP PHONE <br />Muirhead 624 Maulsby Lane Everett <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />G <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE <br />Pettit Corp. <br />9725 32nd Street S.E. <br />Everett 98205 <br />334-7708 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE N <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />V Vy v V ❑ NEW ❑ ADDITION ❑ ALTERATION ;REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />$5,000.00 <br />re -roof shake <br />PROPOSED USE OF BUILDING <br />single Family Residence <br />- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />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 OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMA STBUCTION. <br />SIGNATURE OF C NjgA R AUTMO ED AGENT DATE <br />X 8/21/85 <br />LEGAL DESCMPTIONOFPROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />14-18 131 Grandview <br />LOT —BLOCK —OF <br />_ -- <br />-- <br />JOB ADDRESS <br />624 Maulsb} mane <br />PLUMBING <br />MECHANIC <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY(WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER _—_ <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS —B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUN'i AIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL S <br />SUB TOTAL = <br />PERMIT $ <br />PERMIT S <br />TOTAL FEE $ <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />C,YES []NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$ 5,000. <br />50 <br />50 <br />SIZE OF BLDG, <br />NO. OF STORIES <br />MA%. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRED <br />YES LINO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />50 <br />50 <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALID .TED (1v THIS SPACE) THIS IS YOU( PERMIT— (V$ <br />(M <br />- (-,T Lr) <br />I <br />I <br />5. GRADING <br />8. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />