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Me Evergreen �- - O N ST R U CT I O N <br />OV <br />evereItt ftJqPERMIT PERMIT NO. 14032 <br />CITY HALL 259 8745 <br />EVERETT, WA 9B201 G' COMBINATION ❑ BUILDING ❑ MECHANICAL L� PLUMBING <br />Ci1T [P PnONE <br />MAIL ADDRESS 252 <br />OWNER <br />Bill HNNI< Nelson 4917 West View Drive cEvere rIP "I4DD <br />.ail ennae55 <br />RAL CONTRACTOR <br />Everett B1drs.Inc <br />MAIL ADDRESS <br />5606 Evergreen WaY <br />CLASS Of- Wvnn <br />❑ NEW ❑AUDITION ❑ALTERATION <br />VALUATION O -_ <br />s 1851.00 <br />reroof - composition <br />single family residence <br />EGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUi <br />52 View Acres Div. 2 <br />LOT _ bI OCK _—OF <br />V 4917 West View <br />PLUMBING <br />NO. TYPE OF FV <br />SHOWER <br />FLOOR <br />ROOF DRAINS — <br />_, 777. mnrR — <br />OR <br />353-7161 <br />M <br />EVEREB*301PH <br />REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />I 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 ED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT IPRESUME TO GIVES AUTHORITY TC VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CON TRUCTION. DATL <br />SIGNATVE OF CONTRA TOR O T..HOssppI7ED AGENT <br />1. ♦`1 C_ c69, <br />MECHANICAL <br />____... _...... FEE <br />FEE Nu. <br />AIR COND. UNITS — M.P. EA. <br />REFRIGERATION UNITS — IT EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. _— <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />SUBTOTAL <br />: <br />SUB TOTAL <br />- <br />PERMIT <br />S <br />PEPMIT <br />S <br />TOTAL FEE <br />S <br />TOTAL FEE <br />S <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />RECEIPT <br />NO. <br />SIDE YARD SETBACK STREET SETBACK <br />FEE <br />—ZONE LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />US! <br />❑YES CNO <br />"'PE OF CONST. OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />S 1851 <br />31 <br />0 <br />BUILDING <br />.00 <br />SIZE OF BLDG. NO. OF STORIES <br />)MAX. OCC. LOAD <br />PLUMBING <br />_ <br />-- <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />FIRE ZONE <br />REQUIRED <br />,]YES INO <br />OTHER <br />APPROVALS <br />BY GATE <br />PENALTY <br />U.B.C. <br />9EC.903 (a) <br />1. ENVIRONMENTAL CHECK LIST <br />31 <br />e <br />2. BUILDING PLANS <br />TOTAL <br />3. FIRE HYDRANT <br />PERMIT VALIDATION <br />SPACE) THIS <br />ISr OUR PERMIT <br />d. FIRE PROTECTION SYSTEM <br />WHEN PROPERLY VALIDATED <br />(IN THIS <br />3cvtI <br />J <br />5. GRADING <br />y <br />C:) <br />B, DRAINAGE <br />V <br />ENVIRONMENTAL IMPACT STATEMENT <br />7. <br />B. HEALTH DISTRICT <br />BY <br />APPR. FOR ISSUANCE BY <br />U <br />eem InATION ACC. BY PLANS CHECKED <br />ADDRESS FILE <br />n <br />m <br />