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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION III BUILDING • MECHANICAL • PLUMBING <br />i <br />OWNER MAIL ADDRESS ZIP PHONE <br />ealdine Matteson 2131 McDougal Everett 98201 252-5989 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />I z <br />C <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />3 <br />W <br />Q) m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />F-' Z7 <br />CA) <br />PERMIT <br />❑ COMBINATION <br />g] BUILDING ❑ PLUMBING ❑ MECHANICAL <br />CLASS OF WORK <br />❑NEW ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />$ 700.00 <br />0DEMOLIS14 ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />Patio 161 x 161 w/roof of corregated fiberglass <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIESI <br />LOT BLOCK —OF- <br />NO. <br />- <br />TYPE OF EQUIPMENT <br />FEE <br />_ _ <br />AIR COND. UNITS-H.P. EA. <br />S 1 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />1 <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />I <br />JOB ADDRESS <br />2131 McDougal <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT IIEATERS-R.T.U. <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />NO. <br />_ <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR DANDLING UNIT- C.F.M. <br />BATH TUBS <br />$ t <br />I <br />CLOTHES WASHER <br />1 <br />WATER HEATER <br />DISH WASHERS <br />I <br />- <br />FA. BUILT &CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />1 <br />FLOOR DRAINS <br />1 <br />GAS. SYSTEM: NOOOP OP OUTLETS <br />KITCHEN SINKS & DISP. <br />SUBTOTAL S <br />I <br />BAR SINKS <br />PERMIT $ <br />ROOF DRAINS - RAIN LEADERS <br />TOTAL FEE $ <br />1 <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 114E SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />Of WC I1K 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 />X •T/LQi�--�t-tCp �J�� 5 31 79 <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS -ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />I <br />1 <br />SUB TOTAL <br />RMIT <br />PETAL <br />s <br />FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAn YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />OYES ONO <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAI <br />OTHER <br />PENALTY <br />TOTAL - <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />UNITS <br />OF DWELLING <br />1 <br />$ 700.00 <br />7:00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />1 <br />FIRE ZONE <br />BASEMENT FIRESPRINK <br />LERS <br />REOUIpED <br />OYES ONO <br />I <br />SPECIAL CONDITIONS: <br />1 <br />1 <br />SEC. 303(a) <br />1 <br />--- <br />-- <br />PERMIT VALIDATION <br />WHEN PROPL 13L Y VAL IDAI ED ON 1111S SPACEI THIS IS YOUR PERMIT <br />YOUR RECEIPF'i <br />THANK YOU w <br />B - I dM .79. <br />— <br />-- <br />— <br />AMLICA710N ACCEPTED BY <br />PLANSDIICKED11y. APPROVI11 <br />rOR RSIfANQ RY <br />ADO L:_:: rat ll <br />