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The Evergreen <br />CrNSTRUCTION <br />- <br />CITY <br />everett <br />PERMIT <br />PERMIT NO.07445 <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Richard Cadmn¢ <br />4S11 Rurker Everstt <br />259-6840 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Sion in 3 dim_ <br />4709 Chnnault Reach <br />353-0290 <br />GENERA CONiRALIOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE F <br />It 11 <br />MECHANICAL CONTPACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK (p <br />❑IIEW ❑ADDITION ❑ ❑ NI <br />ALTERATION ❑REPAIR ❑DEMOLITION FENCE SIGN ❑GARAGE <br />VALUAt UP Vr W Vm. <br />DESCRIBE WORK <br />T.i aht WPi aht nl a c t i r I n t tnr inc tallnA nn all <br />PROPOSED USE OF BUILDING <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES G( VERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER 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 CONSTRUCTION. <br />SIGNATU NTRACiOR OR AU ORI AGENT DALE <br />X <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT_BLOCK_OF <br />JOB ADDRESS <br />PLUMBING <br />ME6HA7<IICAL <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 -1- H P. EA. <br />BATHTUB <br />REFRIGERATION UNITS -- HP. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H P. EA. <br />_ <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK B DISP, <br />FORCED AIR SYSTEMS — B.T.U. M EA, <br />DISHWASHER <br />WALL HEATERS —BT.U. M <br />I AUY.DRY TRAY <br />UNIT HEATERS — 8 T U. M <br />(LOTHFS Wl$HER <br />EVAPORATIVE COOLERS <br />_ <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 />_— <br />VACUUM BREAKERS <br />j <br />ISTOVE <br />ROOF DRAINS — RAIN' EADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK. (SERVICE — BAR, ETC) <br />SUB TOTAL <br />SUB TOTAL f <br />PERMIT III <br />PERMIT f <br />TOTAL FEE III <br />TOTAL <br />FEE { <br />SIDE YARD SET13ACK <br />TR <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />LTYES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />1 1 2 5 . 0 0 <br />3 <br />00 <br />SIZE OF BLDG. <br />NO. OF bCORIE.S <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />AYES LINO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />_ <br />1. ENVIRONMENTAL CHECKLIST <br />PENALTY <br />UBC <br />SEC, 303 (a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />3 <br />00 <br />4. FIRE PROTECTION SYSIPM <br />5. GRADIN 3 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />0735 S 0 0 3.00 -- <br />YOUR RECEIPT I <br />THANK YOU <br />5 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMEN! <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLAITS CHECKED 87 <br />4PPR. POR ISSUANCE BY <br />ADDRESS FILE 1 0 APR 80 <br />