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1he EYergreer, <br /> "TY°` � �aNSTRUCTl01� � <br /> everett PERMIT PERMIT NO. 13070 <br /> cin H�u zsae��s <br /> EVERTf,WA 98201 [� COMBINAT.JN [� BUILDINO ❑ MECHANICAL ❑ PLUMBIN(i <br /> � MA;L RDDqE55 C�'Y <br /> Gerald Rnnd 7904 Rainier Drive Everett 98203 353E9�46 <br /> FACNITECT OR DESIGNER M, _ppDRESS CITY ZIP PHONE <br /> GENERAL GONTRRCTOR MAiL ADDRESS CITY ZIP PMONE LICENSE I <br /> 2Wc County Huilders 31029 76 Avenue N.W. Stanwood 96292 629-2270 <br /> MECMANICAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE �ICENSE/ <br /> TO OC AB 868B8 <br /> PLUMBING CONTRACTOR MAi,p00RE5S CITY Z�p PMONE LICENSE� <br /> CLASS OF WORK <br /> ❑NEW �i ADDITION ❑ ALTERATION ❑REPAIR C� DEMOLITION C� FENCE ❑ SIGN ❑ WOOD STOVEIfIREPLACE INSERT <br /> VALLIRTION OF WOflK - <br /> S L��rJO�.�� � <br /> DESCRIBE WORK <br /> Construct Recreation Room <br /> PRJPOSED USE OF BUIL�ING <br /> Single Fam'ly Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGAL pESCRIVT10N O. 'ROPERTY�SMOW BELOW OR ATTACN FCUR COPIES) � APPUCATION AND KNOW TNE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT__BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> SOUTHERLY 62 ft Of LOtS 1 & 2, Bl k 4, WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF a. <br /> ca�.e,.�., u ni PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> � GR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCT ON OR THE <br /> JOB ADDPE55 PERFORMANCE OF CONS UCTION. <br /> SIGNAT E OF CONTRq�TCR OR AU RIZE�AGENi� OATE <br /> 7904 Rainier Drive X � <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF FOUI?MENT FEE <br /> WATERCLOSET�TOILET) AIR COND.UNITS- H.P. EA. <br /> BATHTUB REFRIGERATIOIJ UNITS- H.P. EA. <br /> LAVATORY�WASH BASIN) BOILERS - H.P.EA. <br /> SHOWER GAS FIREO A.C.UNITS-TONNAGE EA. <br /> KITCHEN SINK 3 DISP. FORCED AIR SYSTEMS- B.T.U. M EA. <br /> DISHWASHER WALL HEA7ER5- B.T.U. M <br /> LAUNDRY TFAY UNIT HEATERS- B.T.U. M <br /> CLOTMES WASHER EVAPORATIVE COOLEHS <br /> WA7ER HEATER CLOTHES DRYERS <br /> UNINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- <br /> QF.M. <br /> VAGUUM BREAKERS STOVE- WOOD j <br /> ROOF ORAINS- RAINLEADERS MEiAL FIREPLACE 8 CHIMNEY <br /> SINK�SERVICE - BAR, ETC.) FlFEPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL i SUB TOTAL S <br /> PERMIT S PENMIT { <br /> TOTAL FEE S TOTAL FEE t <br /> $IDE Y�...J SETBACK STREET SETBACK REAR YARD SETBACt( PLAN CHEGK NUMBER PIAN CMECK FEE <br /> 10' & 6' <br /> 84/13070 FEE 56.23 AECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> R-1 . �YES X3F10 FEES VALUA710N E <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> V-N Add'n R-3 1 BUILCING $ 10,500. 86 50 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> � PLUMBING <br /> FIflE ZONE BASEMEN7 FIRE SPRINKLERS - <br /> REOUIREJ MECHANICAL <br /> YES O <br /> APPFOVALS BV DATE OTHER <br /> 7.ENVIRONMEN7AL CNECK LIS7 PENALTV U.B.C. <br /> 2.BUILUING PLANS SEC.9031a) <br /> 3.FIREHYDRANT TOTAI 8E 50 <br /> A.FIRE PROTECTION SVSTEM PERMIT VALIDATION <br /> 5.GRAOING WHEN PROPERLV VALIDATED(IN 7HI5 SPACE)7HISy`IS VO�fUR) PE[RMIT <br /> 6.DRAINAGE � L L 3 .p O l� U. J O — � <br /> 7.ENVIRONMENTALIMPACTSTAiSMENT d <br /> 8.HEALTH DIS7RICT (� <br /> APPLICATION ACC.PV PLANS CHECKED BY APPR.FOR ISSUANCE BV � .� ; n;;C �.: I PT � <br /> EB HWM LC � ��ih il U <br /> ADDRESS FILE I h ' r7 u�l <br />