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the Evergreen CONSTRUCTION <br />.^ <br />CITY OF <br />everett <br />CITY HALL 2590745 <br />EVERETT. WA 98201 <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />OWNER MAIL ADDRESS ZIP 19wNEITT <br />Mr & Mrs Gilbert 4216 South 3rd Everett M <br />,O <br />z <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />een Materials Supply 20624 Blst W Ec3mnds 223-01LEM260331W <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />4-. FIT <br />UMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO, <br />w <br />co <br />PERMIT <br />❑COMBINATION <br />CkBUILDING ❑ PLUMBING ❑ MECHANICAL <br />CLASS OF WORK <br />❑ NEW []ADDITION ❑ ALTERATION X❑REPAIR <br />VALUATION OF WORK <br />S 2,037.00 <br />❑ DEMOLISH ❑FENCE [:]SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />RE -SIDE RESIDENCE - <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT _1-F%-.Q.00K_011 OF T#7A'11 Dim <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S 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 />JOB ADDRESS <br />4216 S 3rd Everett <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <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. <br />BATH TUBS <br />S <br />1 <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />PAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />FLOOR DRAINS <br />I <br />SUBTOTAL S <br />I <br />KITCHEN SINKS & DISP. <br />I <br />BAR SINKS <br />PERMIT S <br />ROOF DRAINS - RAIN LEADERS <br />TOTAL FEE Sl <br />I <br />SHOWER BATHS <br />T141S 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 1 HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE 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 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 7Z�C►_� 5-15-%B <br />aFlrl <br />SERVICE SINKS <br />SUMPS -SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />1 <br />WATER HEATERS — ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />_ <br />I <br />1 <br />SUB TOTAL <br />MIT <br />TOTAL FEE <br />WATER <br />SERVICE SIZE SLOG. SUPPLY <br />512E <br />S icoNTRAc7oROR nuTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHFCK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT+ITE <br />[]YES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY. GROUP <br />TaO -OF <br />UNITS DWELLING <br />UNITS <br />BUILDING <br />S7017.nfi <br />?A- In <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAO <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REQUIRED <br />[]YES ❑NO <br />MECHANICAL <br />OTHER <br />I <br />SPECIAL CONDITIONS: <br />PENALTY <br />SEC. 3071a1 <br />I <br />TOTAL ` <br />24.00 <br />---- <br />PERMIT VALIDATION V y'F�� + <br />WHEN PROPERLY VALIDATED �1 PncE 1 I 1i1YAMITI <br />I <br />vo;ul'klY,1AECEIP I <br />THANK YOU, -:,I <br />!1 I r mar 70 <br />AroLICA110NNSIPIIPPY. <br />FLANtiUILLK108 <br />RPPP 1111ISilIRNCf6Y. <br />e <br />ADDRESS FIE'.- I � `^. '_' - <br />