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�I�YP�� � CONSTRUCTION �� 0-0:1-gz <br />e erect PERMIT PERMIT NO. 08383 <br />CITY HALL 259-8745 <br />EVERETT. WA 93201 ❑ COMBINATION :B BUILDING ❑ MECHANICAL PLUMBING <br />I <br />OWNER MAILADDRESS GIY PHONE <br />Kan Salo 1936 Virginia Everett 98201 252-1923 <br />ARCHITECT OR DESIGNER MAIL ADDRE4 CITY z PHONE <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />$3a8 <br />MECHANICAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />PLUMBING CONTRACTOR MAILADDRESS CITY ZIP PHONE LICENSE If <br />CUSS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR DEMOLITION ❑FENCE DEIGN ❑GARAGE <br />VALUATION OF WORK - <br />S <br />DESCRIBE WORK <br />demolish "A, -Ran <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITYTOVIOLATE ORCANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFCRMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X IQ/6/RO <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />-30 ] �vLlrn tt Div. p <br />RLOar__6a: <br />_ <br />(I �'L?-Z�l-i~ <br />JUB ADCP233 43 \ <br />IS06 Virginia \1 ;_ <br />PLUMBING <br />`i ECHANICAL <br />NO. <br />TYPE OF FIXTURE CIA ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET OILET) <br />-7{j•� <br />AIR COND. UNITS -H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS -H.P. EA <br />LAVATORY (MASH BASIN) <br />- .\ <br />BOILERS - H.P. EA. <br />SHOWER <br />-1- I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />" <br />DISHWASHER <br />WALL HEATERS-B.T.U. - M <br />LAUNDRY TRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER NEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C.F.U. <br />VACUUM BREAKERS <br />STOVE <br />- <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE - BAR. ETC.) <br />SUBTOTAL <br />SUBTOTAL S <br />" PERMIT <br />S <br />PERMIT S <br />_ <br />TOTAL FEE <br />S <br />TOTAL <br />FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONSI. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S <br />00 <br />OO <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />FlRE ZONE <br />BASEMENT <br />I <br />FIRE <br />REOUIRED SPRINKLERS <br />MECHANICAL <br />m <br />