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the Evergreen <br />CITN' OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />000NSTRUCT10% <br />PERMIT PERMIT NO. 15292 <br />❑ COMBINATION IXX BUILDING C' MECHANICAL PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Jim Fisher 2118 Walnut Everett 98201 252-0813 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICEITSEA <br />Goode Construction Co. <br />5832 119th Avenue N.E. <br />Lake Stevens 98258 <br />334-9262 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE A <br />GOODEC20BL4 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE A <br />yN„- •'V, "O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE O SIGN 0 WOOD STOVEIFIREPLACE INSERT <br />$ 2.000.00 <br />PROPOSED USE OF BUILDING <br />Single Family Residence <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 SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONST CTION. <br />SIGNATURE OF ONTRA TOP OR AUT IZED AGENT DATE <br />X <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT_SLOCK_OF <br />Sec. 20 Twp 29 Rge 5 <br />JOB ADDRESS <br />2118 Walnut <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.G. UNITS — TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS — 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 />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIRE'LACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />S <br />SUB TOTAL $ <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />5' <br />STREET SETBACK <br />20' <br />REAR YARD SETBACK <br />20' <br />PLAN CHECK NUMBER <br />85/15292 <br />PLAN <br />FEE 21.13 <br />CHECK FEE <br />RBf'§IT6O. <br />USE ZONE <br />R-2 <br />LOT AREA <br />9000 Sq. Ft. <br />VACANT SITE <br />::YES <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />M-1 <br />NO. OF DWELLING UNITS <br />BUILDING <br />S 2,000. <br />32 <br />50 <br />S1ZE OF BLDG. <br />14' X24' <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />. YES -. NO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />DATE <br />T. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.S.C. <br />SEC..303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />32 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S.GRADING <br />r <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN TH?-rpgA¢E) 7HIJISIYyUR 15TIT [Si <br />U L 113(` <br />Li: <br />YOUR RECEIPT n <br />THANK YOU <br />G. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />JEF <br />APPfl. FOR ISSUANCE BV <br />- 9 SEP 8 5 <br />ADDRESS FILE <br />