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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 B745 <br />EVERETT, WA 98201 <br />C(ISTRUCTION <br />PERMIT <br />❑ COMBINATION ❑ BUILDING N(MECHANICAL <br />PERMIT NO. 07505 <br />❑ PLUMBING <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />OWNER <br />98201 <br />252-8982 <br />Otto J. Arnold <br />1705 Virginia <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE 1 <br />GENERAL CONTRACTOR <br />Same <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSER <br />PLUMBING CONTRACTOR <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION []REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />S <br />DESCRIBE WORK <br />1 f d a it s stem <br />instal orce y <br />PROPOSED USE OF BUILDING <br />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />en <br />single family residce <br />L BE TRUE AND CORRECT. <br />TION AND KNOW THE SAME GOVERNING THIS <br />ALLL PROVISIONS OF LAWS AND ORDINANCES <br />A <br />eaoon ATTACH FouR COPIEsI <br />LEGAL DESCRIPTION OF PROPcWTY,SHow w <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT Bla<_OF <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CPNTRACT, OR IZED AGENT DATF <br />X 4 29 80 <br />JOB ADDRESS <br />1"05 Virginia <br />PLUMBING <br />MECHANICA <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FE- <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA, <br />REFRIGERATION UNITS <br />BATHTUB <br />BOILERS — H P. EA, <br />LAVATORY (WASH BASIN) <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />SHOWER <br />1 <br />FORCED AIR SYSTEMS — B T.0 M EA. <br />r00 <br />KITCHEN SINK 8 DISP. <br />WALL HEATERS — B.T.U. M <br />DISHWASHER <br />UNIT HEATERS —BT.U. M <br />—_ <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERATER <br />ASHER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOODAIN <br />FOUNTAIN <br />Lai <br />AIR HANDLING UNIT — C.F.MREAKERS <br />STOVE <br />INS — RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />VICE — BAR. ETC ) <br />SUBTOTAL <br />SUB TOTAL <br />3 5 <br />—QQ <br />PERMIT <br />S <br />PERMIT <br />S <br />TOTAL FEE <br />5 <br />TOTAL <br />FEE 3 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FLE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />N0. OF DWELLING UNITS <br />BUILDING <br />8 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />REQUIRED SPRINKLERS <br />MECHANICAL <br />8 <br />00 <br />f IVES LINO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />8 <br />GO <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />1342 t 0 0 8. 0 0 <br />1' 0 U R R E C E I PT <br />1 I_.I /^ �, YOU <br />5, GRADING <br />6. DRAINAGE <br />7, ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. By <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />25APR fi0 <br />