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the Evergreen <br />CITY OF <br />everett <br />CIl y HALL 259 8749 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />E <br />UtYNL11 MAIL ADDRESS n' i nuNE <br />First Presbyterian Church 2930 Roclrefel:er <br />ARCHITECT OR DESIGNER MAIL AUDRES$ PHONE LICENSE NO. <br />m <br />7 <br />-i <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Sanford Wright P.O. Box 809 98206 259-4138 223-01-WR IG H3 <br />z <br />278NO c <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />m <br />m <br />PLUMB" 4G CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />U: <br />PERMIT <br />❑COMBINATION <br />❑ BUILDING []PLUMBING []MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION }',ALTERATION ❑REPAIR <br />CI <br />VALUATION OF WORK <br />S 41700. 00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />alter existing lavatorys into a womens lavatory <br />PROPOSED USE <br />church <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH - <br />FOUR COPIES) <br />LOT16-25BLOCK 68OF Plat of Everett <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />_I <br />I <br />JOB ADDRESS <br />2936 Rockefell,:-r <br />SPACE & WALL HEATERS - B.T.U.- <br />UNIT HEATERS-B.T.U. <br />1 <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHFS DRYERS <br />_ <br />i <br />VENTILATION FAN <br />RANGE HOOD <br />i <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. I_T_ <br />BATH TUBS <br />5 <br />I <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE W CHIMNEV <br />I <br />DRINKING FOUNTAINS <br />1 <br />GAS. SYSTEM_: NO OP OUTLETS <br />FLOOR DRAINS <br />I <br />:.,,B TOTAL S <br />_ <br />I— <br />KITCHEN SINKS & DISP. <br />I <br />BAR SINKS <br />I <br />PERMIT S <br />ROOF DRAINS - RAIN LEADERS <br />1 <br />TOTAL FE'.- S <br />I <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID 1- WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED'NITHI N 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 HEREPY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO HE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUT14ORITY TO VIOLATE OR CANCEL THE "ROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />^ 11 2Z/77 <br />/ <br />X <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />1 <br />WATER CLOSETS <br />I <br />WATER HEATERS - ELECTRIC <br />I <br />WASH BASINS <br />1 <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />1I <br />PERMIT $ <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIGNATURE OF CONTRACTOROR AUTI4. AGENT DATE <br />SIDE YARD SETBACK <br />STREETSETBACK <br />REARYARDSETBACK <br />PLAN CI-H CK NUMBER <br />FEES <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />VALUATION <br />FEF. <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />T— <br />I <br />I <br />BUILDING <br />S 4700.00 <br />32 00 <br />SIZE OF BLDG. <br />NO. OF STnmES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLEITS <br />REQUIRED <br />❑YES ONO <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />PENALTY <br />SEC:. 303(a, <br />1 <br />TOTAL <br />32100 <br />PERMIT VALIDATION tt�� jj�� jj�� <br />WHEN PROPERLY VALIDATED(13♦h.6�PAG F$413 LAOR PE RMIT1 <br />4?0 U R REC91 (T) <br />THANK YOU o <br />, <br />B 9 9 FiAI ? 7• <br />— —. <br />— <br />- -- <br />- -- - <br />A"UrAnoN ACLEPIEDBI' <br />l'_ANSCIIEIIKI B BY. <br />APPR0V DHIRISVAW BY <br />J.J.eb <br />ADDRESS Fit E a. r. L •^ • r <br />0 <br />Im <br />