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!h�Ecercrrrn - /O�V�� l�� ■ I O�r <br /> (, �O: <br /> everett PERMIT PERMITNO. 1�� � � <br /> CITY HALL 259�8745 <br /> EVERETT.YJA9B20t [] COMBINATION �j} BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> UYMEfi MRI�AOPRES$ CILY ZIP �'M��+� • <br /> Ralph hlcCarty 1928 Rucker Avenue Everett _96201 <br /> ARCHITECi OR OESIGNEP MAIL PpDFE55 C4Y ZIP PHONE , <br /> GENEN..�.;C"TFACTOR MPIL RDDPE55 CITi .'iP PHONE LICElvSE� <br /> Rich Menzel 1408 Walnut Street Evexett 98201 252-7696 <br /> M[CYANICPL CONTNPCiOR NAIL AODRE55 LI1Y ZIP PIIONE LIGENSC s <br /> MENZER1R205 <br /> PIUMBING GONiRnCTOR MAIL AODRE55 CITY ZIP PNON[ LICENSE• <br /> GU55 OF WORK <br /> ❑NEV� ❑ AODITION ❑ ALTERATION EXREPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFiREPLACE INSERT <br /> vnwnnorv ov woarc <br /> s 3200.00 <br />� DESCPI�E WOPN <br /> Tear off and re-roof residence - Composition — <br /> PPOPOSE�USE Oi BU'�LDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EX�MINED 1'HIS <br /> Single Family Fiesidence APPLICATION AND KNOW THE SAME TO B[ TRUE AND <br /> i.ecn�ecscaianonovar+oPearrisHowee�owoaFirnencourrcovies� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> ��-22 3% Everett Div. 6 GO\'ERNING THIS TVPE OF W09K WILL BE COMPLIED WI7H <br /> e�ocn_oF_ WHETHER SP[CIPIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOFS NOT PRESUME TO GIVE AUTHORITY TO l'IOLATE <br /> OR CANCEL THE PFOVISIONS OF ANY OTHER STATE OR <br /> LOCAL LNVJ REGULATING CONSTRU(:TION OR THE <br /> PERFORMANCE OF CJNSTRUCTION. <br /> JOp ADDRESS SIGNAiU OF CONiPA�T�A ON 4UiHOHIZE�PGENT �P1E <br /> 1928 R�cker Avenue X -G <br /> � n�,P � a/17/84 <br /> PLUMBING MECHANICAL � _ <br /> N0. TY�E OF FIXTURE OR ITCM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) AIR COND.UNITS — H.P.EA. <br /> OATMIU� REFFIGENATION UNITS — HP. EA. <br /> LAVATORY�VJASH BASIN� BOILLRS — H.P. EA. _ <br /> SHOWER GAS FIRFD A.C.UIJITS — TONNAGE EA. _ <br /> HIiCHEN SINK R DISP. FORCED AIR SVSTEMS— 8 LU. M EA. <br /> DISHWASHER WALL NEATENS— B.T.U. M <br /> LAUNDRY TRA'P UPIIT MEATERS— B.T.LL h1 <br /> CLOTHESWASHER EVAPOflATIVE COOLERS <br /> WATER MEATIER CLOTHES DRVERS <br /> URINAL VEIJTILATION FAN <br /> DPINKING FOJNI'AR� __ RANGE MO00 _ � <br /> FLOOR DRAIP'� AIP.HANDLING UNIT— GP.M. <br /> STOVE — WOOD ~� <br /> VACUUM BREAK[RS �; <br /> ROOF DRAIN'i— RFINLEADERS ME�i Al FIREPJ.CE 8 CMIMNEY <br /> SINK(SERVIC[ — BAR,ETC.) FIREPLACE INSERT <br /> NEAT PUIdP <br /> H �- <br /> — F3 ". <br /> SUB TOTAL S SUfi TOTAL f . U7 F <br /> PERMIT S Pf.RMIT _5 V ' <br /> TOTAL FEE � S TOTAL FEE S M T <br /> SIDE YAR�SETBACK STREET SETBACR HEAP VARO SETBACK PLAN CMECK NUMBEF PLAN CMECK FEE r <br /> .� . <br /> FEE RfCE1PT KQ � r <br /> 1�5E ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> VES .�.NO � ~ <br /> -rvPE OF WNSL OCCUPANGV GROUP NO.OF OWELLING UNITS � ' <br /> ( ew�ouac s 3200.00 94 50 � ; <br /> � SIZE OF BLDG. NO.OP STORIES IdPY.OCC. LOAG -- <br /> PiUMBING � I <br /> � — '— _ <br /> � Flfi[ZONE IBASEMEN7 IRFESPRWKLEPS MECMANICAL O � <br /> FEOUIRED � <br /> � YES NO ."�n �� <br /> O1HER <br /> iAPPROVALS_ _. _ BY _ OOiE _ -- � � � <br /> t ENVIRONMENTA,CHECK LiST PENALTI' — SECC3031a) __ � �, <br /> 2.DUILDING PLANS <br /> -- tora� 44 50 �' . <br /> 3.FlR[HVORANT � <br /> d.FIRE PROTECI'ION SYSTEM PERMIT VALIOATION ` � <br /> S GFADING WHEN PROPERLY VAI.IDATED IIN T�IS.•SPACE� TH13 IS YOUR f�ER7J1T I.�' <br /> � il � � <br /> 8.DFAINAGE , <br /> 7.ENVIRONME4TALItdPACTSTATEMENT i � � <br /> B.HEAITH DISTRiCT ' � � ' <br /> APPLIJFTION ACG. BY PLANS CMECKED BV APPR. FOF ISSUANCE BY <br />