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= CITYOF � CRUCTION <br />O%%71 .. <br />evepp� O ETRM1T PENMIT NO. <br />CITY HALL MA745 ❑ COMBINATION [�BUILDINQ ❑ MECHANICAL ❑ PLUMBING <br />EVERETT. WA 98201 <br />RE <br />G p <br />98201 252••3809 <br />Russel Bean 1628 Walnut ^.N ZIP PHONE <br />Roof Co. 2916 State Street <br />MAIL ADDRESS <br />Everett <br />PHONE uH,cnx . <br />98201 258-4646 <br />PHONE LICE.SE <br />RI VE RR *302TO <br />Dams, LICENSE <br />n NFW ❑ADDITION ❑ALTERATION XWEPAIR DDEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />)ESCRIBE WORK <br />Hot built up re-r< <br />'ROPOSED USE OF BUILDING <br />Residence <br />LEGAL DESCRIPPON OF PROPERTY (SHOW <br />LOT 19-20,LMI' 3270F <br />Walnut <br />PLUMBING <br />— RAINLEAG; 3 - <br />- GAR. ETC) - — <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />TALL OF LAWS AND YPE OFVISIONS ORDINANCESWHETHERGOVERNING I <br />WORK WILL COMPLIIEDW WITH S EC F SPECIFIED <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 CONSTRDUCTION. <br />SIGNATURE OF CDNIRACTOR OR AUTHORIZED AGENT <br />ATE <br />X Check #4290 6/23/80 <br />MECHANICAL <br />AIR <br />). UNITS — H.P. E <br />1A7ION UNITS - <br />- H P. EA. <br />D A C UNITS <br />AIR SYSTEMS — <br />ATERS — B T.U. <br />nTons — B.T.U. <br />SIDE YARD SETBACK S1 REET SETBACK <br />REAR YARD SETBAG• <br />FEE <br />RECEIPT NO. <br />— <br />USE ZONE LOT AREA <br />VACANT SITE <br />]YES l INO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />- <br />s <br />10 00 <br />LOING <br />964.00 <br />SIZE OF BLDG NO. OF F'ORIES <br />MAX. OCC. LOAD.LUMBING <br />FIRE ZONE PASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />EYES 11NO <br />APPROVALS <br />BY DATE <br />OTHER <br />U.B.C. <br />1. ENVIRONMENTAL CHECKLIST <br />PENALTY <br />SEC. 303(a) <br />�'0 00 <br />2, BUILDING PI ANS <br />TOTAL <br />3. FIRE HYDRANT <br />SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE T <br />IS YO A� ..� <br />T� T UU• O O <br />d. FIRE PROTECTION <br />; <br />� <br />5. GRACING <br />6. DRAINAGE <br />RECE�P <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />YO U R <br />Y0 <br />HEALTH DISTRICT <br />ti'tANI� <br />B. <br />APPLICATION Ac.C. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />,i <br />