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the Evergreen <br />CONSTRUCTION <br />CITY OF <br />everett <br />PERMIT <br />CITY HALT 15908M <br />f VT PI 71, IAIFN LT 14 <br />9nml <br />OIF, °I.°„^Y <br />"°4 <br />BUILDING MECHANICAL <br />Ill if LnPVLNI <br />evereti <br />PLUMBING ,e <br />OWNER MAIL. ADDRESS ZIP PHONE <br />Dr. Ed Diwvs nl; 252-1412 <br />f> _77 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />Hark £O1RIOn8or <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO, <br />R. S. T. Construction <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Judd 6 Black <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />03 <br />PERMIT CLASS <br />®BUILDING ❑ PLUMBING ❑ MECHANICAL <br />OF WORK <br />❑ NE.N ❑ADDITION ❑ALTERATION ❑REPAIR <br />� <br />Z <br />L <br />VALUATION OF WORK <br />5,000.0o <br />❑DEMOLISH []FENCE []SIGN ❑SWIMMING POOL <br />W <br />G <br />DESCRIBE WORK <br />Garage Addition <br />^ j (� <br />L T U <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL []OIL <br />❑GAS. ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FDT`1li77Wlis) 12 Bvarett <br />LOTBLOCKOF <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-N.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />++ <br />21 _'5 1 <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />1 <br />JCR ADDRESS <br />_16fl_ Rucker <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. NI <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGEHOOD <br />1 <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OFIXTURE OR ITEM <br />F <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />_ <br />SHOWER <br />_ <br />KITCHEN SINK & DISP. <br />SU I TOTAL 5 <br />I <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTAL FEE S <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AF TER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL. THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />. ,�,- y„� <br />x (��� <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />HOOF DRAINS-R AINLEADE RS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT L <br />TOTAL FEE s <br />SIGNATUREOF CONT RACTORORAUTH. AGENT DATE <br />SIDE YARD SETBACK <br />S'F <br />STREET SETBACK <br />201 <br />REAR YARDSETBACK <br />20, <br />PLAN CHECK NUMBER <br />77/253 <br />PLAN CHECK FEE <br />FEE 20.80 RECEIPT • lNO. <br />i <br />USE ZONE <br />R-d <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO.DWELLING <br />UNITS <br />I <br />BUILDING <br />$5.000.00 <br />321 00 <br />SIZE OF BLDG. <br />NO. OF -STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />3 <br />BASEMENT <br />no <br />FIRE <br />R ❑Y <br />SPRINK L$E RS <br />EO DOESJO <br />MECHANICAL <br />1 <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />-- <br />PENELTY <br />SEC. 303 (a) <br />I <br />TOTAL <br />I Y fj <br />I <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />0 <br />APPLICATION ACCEPTED EV: <br />PLANS CHECKED BY: APPROVED <br />FOP ISUANCF BY. <br />