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Idr Lcertrrrn �O��ST R U CT I O N <br /> G7V'C� � <br /> everett PERMIT PERMIT NO. 141R� <br /> CITY HALL.59�B7a5 <br /> eveaErr. wn seso� � COMBINATION � BUILDING C' MECHANICAL ❑ PLUMBING <br /> �yyryEq MPIL ADDRE55 ��TY ZIP PMONE <br /> Victor F. Nelson 2906 Victor Place Everett 98201 259-3945 <br /> ARLMITEGT OR DESIGNER MAIL RUORE55 LITY ZiP PMONE <br /> GENERAL GONTRAGiOR MRIL ND�RE55 ��TY I�P FHONE LIGENSE• <br /> Same <br /> MEGHRNIL4l CONiR�CTOR MPIL AD�RESS CITY ZIP PHONE LiCENSE Y <br /> PWMBINGGONTFAGTOR MPILlDDR[55 QTY ZIP VMONE UCENSE• <br /> GU55 OF WORK <br /> ❑NEW I�ADDITION O ALTERATION �Q3IEPAIR ❑ DEMOLITION � FENCE ❑ SIGN ❑ WOOD STOVFIFIPEPLhCE INSERT <br /> VALUATION OF WORN <br /> ! Z�Q0.00 <br /> DESCRIBE WORK <br /> repnir garage and re-roof _ <br /> rnovoseouse oF am�oir+c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> single family residence APPLICATION AND KNOW THE SAME TO BE TRUE AND � <br /> iwn�aEscaialion oF aaorEarr�sHow eE�ow an nTrncn voun coaiesr CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES � <br /> Ptn 3-4 6 Ready Land Co's lst GOVERNING THIS TYPE 0�WORK WILL DE COMPLIED WITH � <br /> LOT_BLOCK_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPT� OR <br /> LOCAL LAW REGULAT�NG CONSTRUCTION OR THE <br /> PERFORMANCE �F CONSTRUCTION. ,_, H <br /> JOB ApOPE55 SIG i E O%GONiR CTOR OR TNORI2ED AGENi DRTE �.] h] <br /> 2906 Victor Place X�� 11/20/84 �..� � <br /> y <br /> PLUMBING MECHANICAL � p <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> WATER CLOSET�TOILETI AIF CONO.UNITS — H.P.EA. '�' <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. � <br /> LAVATORY(WASH DASIN� BOILEFS— H.P.EA. <br /> SMOWEF GAS FlREO A.C.UNITS—TONNAGE EA. Z <br /> KITCMEN SINK 8 DISP. FOPCED AIR SYSTEMS— B.T.U. M EA. � � <br /> DISHWASHER WALL MEATERS— BT.U. M " � <br /> LAUNOAV TR4Y UNIT MEA7EFl5— B T.U. M __ K rrrr�� <br /> CLOTHES WASHER [VAPORATIVE COOLERS � y7 <br /> WATER MEATER CLOTHES DRYEFS 7 3 <br /> URINAL VENTILATIOR FAN � �T� <br /> DRINKING FOUNTAIN RANGE MOJD �~j7 <br /> FLOOR ORAIN AIP.MANDLING UNIT— C.F.M. � � <br /> VACUUM BHEAKERS STOVE —WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIPEPLACE 8 CHIMNEY _ Nn <br /> SINK(SERVICE— BAR.ETC.) FIPEPLACE INSEflT . � <br /> MEAi PUMP <br /> Z <br /> S118 TOTAL i SUB TOTAL f � <br /> PERMIT f PERMIT 5 H <br /> TOTAL FEE f TOTAL FEE f N <br /> SIDE VARD SETBACK STHEET SEiBACK REAR YAFD SETBACK PLAN CMECK NUMBER PLAN GHECR FEE � <br /> FEE RECEIPT NO. H <br /> USE ZONE LOT AREA VACANT SITE f EES VALUATION FEE "I <br /> YES NO <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNIiS . <br /> BUILDING S 17 SO <br /> SIZE OF BLOG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINK�ERS MECNANICAL <br /> REOUIRED <br /> YES NO <br /> OTHER <br /> APPROVALS BY OATE — <br /> 1.ENVIRONMENTAL CHECK I.IST PENALTV U.8 C. <br /> SEC.J03(a) <br /> 2.BUILDINGPLANS TOTAL 1� SO <br /> 3.FIRE HYDRANT <br /> d.FIRE PROTECTION SYSTEM PERMIT JALIDATION <br /> WHEN PflOPERLV VALIDATED pN TNIS SPACE)TNI$IS VDU,P RERMIT _ (y <br /> S.GRADING � � ' - � <br /> e.DRAiNAGE e--� <br /> 7.ENVIRONMENTAL IMPACT STATEMENT '� <br /> B.MEAI.THDISTRICT �� ' � <br /> APPLICATION ACC.BY PLANS LMECKEO BY APPR. FOH ISSUANCE BY . . <br /> n.I'i ,.._. ., I ' . <br />