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The Evergreen <br />o `` ` � <br />CITY OF o <br />.-r;ONSTRUCTIOP'- :- c <br />everett CITY HALL 2598745 p PERMIT PERMIT No. 16190 C <br />E. <br />EVERETT. WA 98201 r] COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER 1.•AIL ADDRESS <br />CITY ZIP .-'l PHONE <br />Maurice A. Preston 1917 McDougall Everett 98201 Z$2-0560 <br />ARCHITECT nR ncciru <br />GENERAL CONTRACTOR MAIL ADDRESS <br />Self QTY ZIP PHONE LICENSE4 <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />CITY ZIP PHONE <br />LICENSE 0 <br />PIUMeB1N� CONTRACTOR MAIL ADDRESS <br />SS 11 CITY ZIP PHONE LICENSE � <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />5 <br />Bedroom & Bath addition <br />PROPOSED USE OF BUILDING <br />Single family home <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />9-10 385 Everett Div. P <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LOT—BLOCK__OF <br />GOVERNING THIS TYPE OF WORK WILL <br />BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERLA IT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE <br />OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />g <br />JOB LunccccDougall <br />1`1 M <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR <br />, <br />OR AUTHORIZED AGENT DATE <br />X 3/10/86 <br />PLUMBING _ <br />MECHANICAL Ci e C $ �4 <br />NO. 1) PE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />WATER CLOSET(TCILET) <br />FEE <br />BATHTUB <br />AIR COND. UNITS — H.P. EA, <br />I LAVATORY(WASH BASIN) <br />REFRIGERATION UNITS — M.P. EA, <br />1 SHOWER <br />2 OO <br />BOILERS — H.P. EA. <br />KITCHEN SINK & DISP. <br />2 00 <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />DISHWASHER <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />UNIT HEATERS — B.T.U. M <br />WATER HEATER <br />EVAPORATIVE COOLERS — <br />CLOTHES DRYERS <br />URINAL <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />VACUUM BREAKERS <br />AIR HANDLING UNIT — C.F.M. <br />ROOF DRAINS — RAINLEADERS <br />_ <br />STOVE — WOOD <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />,_— <br />SUB TOTAL <br />i <br />6 <br />00 <br />PERMIT <br />f <br />— <br />— <br />SUB TOTAL f <br />PERMIT f <br />TOTAL FEE <br />S 6 00 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />TOTAL <br />PLAN CHECK NUMBER <br />FEE f <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST, <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$6000.00 <br />gjE <br />LWk <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC, LOAD <br />PLUMBING <br />6 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />YES NO <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 />4. FIRE PROTECTION SYSTEM <br />62 50 <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />E.DRAINAGE <br />L_1 <br />Renewal (lI( . Lp7ENVIRONMEpermit #10879 <br />NTALIMPACT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BV <br />APPR. FOR ISSUANCE BY <br />M.M. <br />L.C. <br />YOU <br />ADDRESS FILE I II.IR i 6, <br />