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�heErCgvcOF rONSTRUCTION - <br /> everett PERMIT pERMIT NO. 09397 <br /> CITY HALL 259�8745 <br /> eveaErt.wn se2oi ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL X$� PLUMBING <br /> OWN[H MAILPUDRL55 CIiY 21P PIIONE <br /> Michael L. Holbrook 1201 Rucker Everett 98201 252-7460 <br /> ARCMITECLORp[SIGNER MNILAD�HE55 C11V ZIP PMONE <br /> G NERA�('qNTRRCiOR MPIIADDRE55 <br /> wner C�TY 21P CMONE LICENS[� <br /> M[CMhNiCntCANiRACiOR NAILADDRE55 QTY ZIP PMONE IiCENSE♦ <br /> VWMBINGLONiqnCiOF MqRADDRE55 Cliv ZiP PnON[ UG[NSE/ <br /> CV.55 OF WORrc <br /> ❑NEW ❑ADDITION XDIIALTEMTION []REPAIR ❑DEMOLITION ❑FENCE L�SIGN ❑GARAGE <br /> V�LUAiION OF WORK <br /> �00.00 <br /> DESCNI E WORN <br /> Rep ace and relocate bathroom fixtures and plumbing <br /> reorosEo use oF emimNc — — <br /> Residence I HEREBY CERTIFY THAT I HAVE REhD AND EXAMINED THIS A!'- <br /> �ccntoescairnoNOFanoaearviSNowee�owoaanncNFouacoai�s� PLICATION AND KNOW THE SAME TO BE TRUE AND CORREC'i. <br /> ALL PROVISIONS OF LAWS AND ORDIPJANCES GOVERNING THIS <br /> �ot eioc�_oc TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEU <br /> H[REIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PRO• <br /> VISIONS OF ANY OTHER STATE OR LQCAL LAW R[GULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JOB ADORE55 SIGNAiURE OF fqN�R4CT q O�UIHORIZEO AGENi � pAiE <br /> 1201 Rucker X ' . 6/18/81 <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FIXTUHE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CIOSET QOILET) AIR COND UNITS—HP.EF <br /> BATHTU� REFRIGERATIGIJ UNITS—H.P.EA <br /> IAVATORY(WASH BASIN) BOILERS—HP EA. <br /> SHOWEfi GAS FlRED AC.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8�ISP PpqCED AiR SVSiEMS—BTL. M EA. <br /> DISHIYASHER WALL HEATERS—O.TL. M <br /> LAUIlDPY TRAV UNIi HEATERS—B T.U. M <br /> CLOTHES WASl1ER EVAPORhTIVE COOLERS <br /> WAT[R HEATER CLOTIiE$DHY[RS <br /> UNINAL VEN'ILATION FAN <br /> DRINKING FOUNfAIN RANGE HOOD <br /> FLOOR DRAIN AIR HAIlDLING UNIT— GF.M. <br /> VACUUM BREAKERS STOVE <br /> HOOF DRNNS—RAMLEADERS METAL FlREPLACE 8 CHIMNE� <br /> SINK�SERVICE—BAF.ETC.� <br /> SU6 TOTAL ' <br /> SUBTOTAL f <br /> PERMIT f PERMIT S <br /> 707A1.FEE f TOTAL FEE f <br /> SI�E YFRD SEiBACK STRCE7 SE i f1ACK REAP 1'ARD SETBACK PLAN CHECK NUM�ER PLAN CHEGK FEE <br /> PEE P[CEIPT NO. <br /> USE ZONE LOT ARFA VACANT SITE <br /> L!1'ES LNO FEES VALUATION FEE <br /> TYPE OF CANST. OCCUPANCY GROI/P NO.�F DWELLING UNITS <br /> BUILDING § <br /> SIZE OF BLOG NO.OF STORIliS MA%.OCA�OAD <br /> PLUMOING 9 OO <br /> FIPE ZONL BASEMEM RPE$PHINKL[RS <br /> REOUIR[D MECMANICAL <br /> IIVES I7N0 <br /> APPPUVALS 0Y OATE �THER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U B.C. <br /> 2. BUILDING PlANS SEG.303(;� <br /> 3. FlRE HVDRANT TOTAL 9 OO <br /> a. FIRE PROTECTION SYSTEM PERMIT VALIOATION <br /> WHEN PHOPERLY VALIDATEU pN THIS SVAC[I THIS IS YOUR?CF,MIT <br /> 5. GRADING <br /> G. DRAINAGE . . � � r � "— � <br /> Z ENVIHONMENTALIMPACTSTATEMENT _ M <br /> e. HEAITH DISTRICT . . Q7 <br />