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., <br /> , <br /> �i <br /> ,h��.�;K�POF ; CONSTRUCTI(' N <br /> e�erett pERMIT PERMIT N0. 12417 <br /> CITY HALL 759E7d5 <br /> EVEfiETT,WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OKNEfl MPIL AOORESS CITY 21P PMONE <br /> • Gayland Hudson 2220 Rockefeller 252-6954 <br /> � �RCMITEGT OR DESIGNER MRIL ADDRE55 CIIY 21P PHONE <br /> GENEa�L CONTR�GTO.^. IAIL ADDRES: CRV 21P PMONE IICENSE� <br /> J' s Contractinq 2220 Rockef.eller Everett 98201 259-1507 50786 <br /> MECNANICnL CONTRACTOR MAIL APORESS QTY ZIP PHONE LICENSE� <br /> PLUMBING CONTRACTOR MAIL AJORESS CITY ZIP PMONE LICENSE I <br /> � <br /> , CU55 OF WORI. <br /> ❑NEW ❑ AD�ITION ❑ ALTERATION {,�{PEPAIFi O DEMOLITION O FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br /> VALUATION OF WORN <br /> f 855. 00 <br /> OESCRIBE WORK <br /> re-roof composi+_ion <br /> PROPOSED USE OF BUI'_DING <br /> single family residence IHpREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHIS <br /> AP. LICATION AND KNOW THE SAME TO BE TRUE AND <br /> IEG�I OESCNIPTION OF PROPERTY�SHOW BELOW ON ATiAGN FOUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT19�ZBLOCN 47 oF Everett 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 /> I OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PER MANCE OF CONST UCTION. <br /> I JOB nDDRESS 51 ATU OF C TRA�OR O}i U 2E�pGENT OATE <br /> � 2220 Rockefeller X d'Y 9/13/83 <br /> � PLUMBIN6 ME ANICAL <br /> � NO. TYPE OF rIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> I WqTERCLOSET�T/`ILEn AIH WND. UNITS— H.P. EA. <br /> i <br /> � �ATHTUB AEFRIGERAT�ON UNIiS — H.P. EA, <br /> , LAVATORV(WASM BASIN) BOILERS— H.P. EA. <br /> , SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> � KI7CHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISMWASHER WALL HEA7ER5— B.T.U. M <br /> LAUNDRV TRAY UNIT MEA7ERS— B.T.II. M <br /> CLOTHES WASHER EVAPORHTIVE COOLERS <br /> WATER HEATER CLOTHES DRVERS <br /> URINAL VENTILATION FAN � <br /> DRINKING FOUNTAIN FANGE MOOD <br /> FLOOR DRAIN AIR HANDI.ING UNIT— C.F.M. <br /> � VACUUM BREAKEfiS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE d CHIMNEY <br /> � SINK(SERVICE— BAR, £TQI FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PERMIT f <br /> TOTAL FEE S 70TALFEE S <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CMECK NUMBER PLAN CHECK FEE <br /> � FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE — <br /> �:YES -NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILDING $ BSS. 16 OO <br /> 512E OF BLDG. NO.OF STORIES MAX.OCC. LOAG <br /> PLUMBING <br /> FIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> • REOUIRED <br /> :-:YES � -.NO <br /> APPROVALS BY DATE OTHER <br /> 1.ENVII70NMENTAL CMECK LIST pENALTV U.B.C. <br /> SEC.309�a� <br /> 2.BUILDING PLANS <br /> 3.FIREHYDRAN7 TOTAL 16 00 <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> . S.GRADING WHEN PROPERLY VALIDATED(IN TMIS�S��E)THI�I�Y�I�Fi i�qM1T _ � <br /> 6.�RAINAGE �) � � ay'1 <br /> � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT N <br /> 8.HEALTH DIS7RIC7 Y�U-R R E C E i PT � <br /> APPLICATION ACC.BY PLANS CHECKED AV APPR. FOR ISSUANCE BY <br /> TH.�NK YOU <br /> I 3 �' 8 3 <br /> AL`DRE55 FIL[ <br />