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rhe£reTYe0 <br />CO►'STRUCTION <br />-'-` <br />I0 <br />CITY1 <br />everett <br />PERMIT <br />PERMIT NO.07664 <br />CITY HALL 259.8745 <br />❑ COMBINATION BUILDING ❑ MECHANICAL <br />PLUMBING <br />EVERETT. WA 98201 <br />OWNER <br />MAIL ADDRE55 CITY <br />ZIP <br />PHONE <br />Orlo Fuller 6702 - 220th SW Mountlake <br />Terrace 98043 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP BR-OHVL K <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />LICENSE <br />Randall S. <br />Brockway 9510 232nd SW Edmonds 98020 <br />546-1858 <br />MECHANICAL CONTRACTOR <br />MAIL DRESS CITY <br />AD <br />ZIP <br />PE LICENSE <br />HON <br />PHONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />CLASS OF WORN <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />f --- - - <br />DESCRIBE WORK <br />L 1 <br />xepaar a re iau: 1D J J lA. <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />DU lex rental <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DESCRIPTION OF PROPERTY 15NOW BELOW DR ATTACH FOUR COPIES <br />15&1��}85 oett Div I'p" <br />Plat Of Ever <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT <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 />CONST ION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIG URE ; AU' ENT DATE <br />JOB ADDRESS <br />(CONT��OR <br />PLUMBING <br />HANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS —HP EA. <br />_ <br />BATHTUB <br />P�FRIGERATION UNITS — H.P EA <br />LAVATORY (WASH BASIN) <br />BOILERS — N.P. EA. <br />GAS FIRED A C. UNITS — TONNAGE EA. <br />SHOWER <br />KITCHEN SINK 8 OISP. <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 COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />SUB TOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />TOTAL <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />C'YES LINO <br />FEES <br />/ALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />BUILDING <br />a 800.0C <br />8 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />REQUIRED SPRINKLERS <br />MECHANICAL <br />❑YES LINO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC. 303 (a) <br />2 BUILDING PLANS <br />TOl'AL <br />8 <br />DO <br />3, FIRE HYDRANT <br />_ <br />FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />(n 9 ii <br />2 8 1118 S E+ 0 9. 0 O <br />5. GPADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />YOUR R E C I-' E <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />THANK YOU <br />ADDRESS FILE 3 Q WAY 9O <br />