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7hr Errr,reen <br />i Y OF <br />everett <br />CITY HALL 2598745 <br />EVERETT. WA 98201 <br />`ONSTRUCTIONO <br />PERMIT PERMIT NO. 15594 <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Evan L. Anderson 4967 Vista Pl Everett, IVA 98203 259-6701 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY Zh PHONE <br />GENERAL CONTRACTOR MAI'_ ADDRESS CITY ZIP PHONE LICENSE 4 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEFIREPLACE INSERT <br />WI 1 1 li <br />Install Airtight IVoodstove <br />PROPOSED USE OF BUILDING <br />Single Family Residence <br />' HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />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 STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRU ION. <br />SIG T RE OF CONTZAr,r�0 H0RI pAGENT DAZE <br />X �r o�oL a>----10/17/85 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT -BLOCK -OF <br />JOB ADDRESS <br />4967 Vista Pl <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPI',9NT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />_ <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK& DISP. <br />FORCED AIR SYS' EMS — B.T.U. M EA. <br />DISHWASHER — <br />WALL HEATERS — B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />1 <br />STOVE — WOOD <br />7 <br />50 <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />i <br />SUB TOTAL f <br />7 <br />50 <br />_ <br />PERMIT <br />S <br />PERMIT f <br />10 <br />00 <br />TOTAL FEE <br />f <br />TOTAL FEE $ <br />17 <br />50 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PI AN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />:,YES CNO <br />FEES <br />VALUATION <br />FEE <br />TYPF, OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIREO <br />YES NO <br />MECHANICAL <br />OTHER <br />APPROlALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B C. <br />SEC. 303(a) <br />2. BUILDING PLANS <br />TOTAL <br />0. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VAL:DhT ED (IN THIS SPACE) THIS IS YOUR PERMIT <br />4 26 8 $ 0 1 7.5 0 -- v <br />, <br />YOUR RECEIPT <br />i! !;11.iv YOU <br />S.GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />N.N. <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />1 7 OCT 85 <br />