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e <br /> ihc Evcrgrcen CO r'ST R U CTIO N <br /> CITY OF <br /> everett PERMIT pERMIT N0. OHOOZ <br /> CITV H�LL'259�B745 <br /> eveaerr,wn �azo� ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUMBING <br /> MAIIADDRE55 CRY ZIG PMONE <br /> OWNEA <br /> DU MAIL PD�PC55 GTY ZIF PHON[ <br /> NRC111iCCi OR D[SIGN[R <br /> GENCAAL CONiRPC10R M1Nil ADORE55 CITY ZIP FHONE LICEHSC� <br /> TIiTTARI]TN P n BOX 53�R FVF'RFTT 9A90F, 7"ld—�i(11R nIITrnrni 7flr. n f <br /> MEGNFYICAICANTRACTOR <br /> MAI�AODRE55 GRV ZI PNONE LICENSL <br /> PWMBINufANTRAGTOB MAIIADDRE55 C�TY 2iP PHONE LICENSE� <br /> CU55OF WORK <br /> �NEW ❑ADDITION ❑ALTERATION ❑REPAIP ❑DEMOLITION ❑FENCE ❑SIGN GARAGE <br /> VALUAtIOH OF WORK <br /> S <br /> �[SCRIBE WORK <br /> COMM I <br /> PROPOS[D USE O�OUROiNG <br /> COMMUNITY BUILDI�_ I HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS AP� <br /> � iecn�oescamnor�oFraoPenrr�sioweeiowonnrrna�rouacoPics PLICATION AND KNOW THE SAME TO BE TRUE �ND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ioi eiocK 12 oF �`�-4 Tri � TYPE OF WORK WILL BE COIdPLIED WITH WHETHER SPECIFlED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> AddltiOri Di PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTF{UCTION O�YI�E PERFORMANCE OF CONSTRUCTION. <br /> SIGNhTJRE�J�.ONiRPCi 1 N PUTRORIZE��GLNi pFiL <br /> JO�tiVUR[55 ,� � <br /> �� � 1'���_..�i�_ <br /> PLUMBING MECHANICAL `—' <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WAtER CIOSFT�704ET� AIR CCtJD UNI75—HP.GA <br /> RCFIiIG[HATION UNITS—HP EA <br /> BATHiUf3 <br /> LAVATORV(WASN BASIN) UOILERS—H P [A <br /> GAS FlRED AC.UNITS—TONNAGE EA. <br /> SHOW[R <br /> KITCHCN SINK 8 DISP. FORC[D AIP SYSTEMS—B T.U. �+��A- <br /> VJALIH[ATERS—E�TL. M <br /> DISHWASNER <br /> LAUNDRYTRAY <br /> UNIT IIEATERS—B TL. M <br /> EVAPORATI\'i COOLERS <br /> CLOTHES WASHER CLOTHES�RY[RS <br /> WAT[R IifATER <br /> VENTILATION FAN — <br /> URINAL <br /> DRINKING FOUIJTAIN RANGE HOOD — <br /> AIR HANDLING UNIT— QF.M. __ <br /> FIOOf�DRPIN <br /> VACUU�d 9FEAK[RS STOVE <br /> ROUF DRAINS—RAINLEADERS METAL FlREPLACE 8 CHIMNEV <br /> SINK�SEflVICE—8AR ETC I <br /> SUB TOTAL SUBTOTAL S <br /> PERMIT S PEflMIT E <br /> TOTAL FEE S TOTALFEE S <br /> SIDE YARO SET�ACN SiRE6T uETBACK REAfl VARD SETBACK PLAN CHECK NUMBER PLAN CHCCK FEE <br /> 6 Feet 20 Feet 20 Feet FEE aeceiPT rao <br /> USE ZONE LOT AREA VACAIJT SIT[ FEES VALUATION FEE <br /> !XYES CNO — <br /> R-1 <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> � BUIIDING $33902. 00 139 00 <br /> SIZE OP BIOG NO. F � ORIES MA%.00C.LOAD <br /> 32x39 (10II8) ]. PLUMBING <br /> FIREZON[ BASEMENi pEOUIRED HLERS M[CHANICAI <br /> None I1YL5 I iN0 <br /> APPNOVALS BY OATE �TNER <br /> t. ENVIRONMENTALCHECKLIST PENALTY UBC <br /> SEC.303(a) <br /> 2. BUILDING PLANS TOTAL <br /> 3. FIREHYDRANT 139 <br /> 4, fIRE P�OTECTION SYSTEM PERMIT VAUOATION <br /> WHEN PROPERLY VALIDATEC��1N THIS SPA�CEf TO I�IS YO��E��+�T, O O ��N � � <br /> 5. GRADING � � � 7 <br /> Q <br /> 6 DRAINAGE , <br /> 7 EN:IHONMENTALIMPFCTSTAiEMENT ���i� � RtLE�� <br /> B. NEALTN DISTRICT /� �1 ^�Q <br /> APPLICATION ACC.BY PIANS CHECKED BY APPR.FOR ISSUANCE OY ; � -�/���Y Y Y l.� �+ <br /> 1��� <br />