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dlr Ecrrcrrrn <br />(n�cr <br />everett <br />CITY HALL 259-8745 <br />EVERETT, WA 90201 <br />I_ CONSTRUCTION' <br />PERMIT <br />❑ COMBINATION )0 BUILDING ❑ MECHANICAL <br />PERMIT NO. 14 9 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />LBL INVESIMENTS 1630 SUNSET HIWAY EAST WENATCIEE WA 98801 509-884-5201 <br />ARCHITECT OR DESIGNER MAII. ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />SAME <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL. ADDRESS CITY ZIP PHONE LICENSE A <br />Cl NEW Cl ADDITION §I ALTERATION ❑ REPAIR Cl DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />% 2,500.00 <br />PARTITIONS FT DOORS <br />PROPOSED USE OF BUILDING <br />HEALTH SPA <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 PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PR VISIONS OF ANY OTHER STfTE OR <br />LOCAL LAW REG LATING CONSTRUCTION OR THE <br />PERFORM OF ONSTR CTION. <br />SIGN ATU CO R CT OR AUTHO IZED AGENT DATE <br />Tuuisf 6/11/85 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELCW ORATTACHFOUR COPIES) <br />LOT 8 BLOCK 23 OF SOUTH PARK ADDN <br />JOB ADDRESS <br />4210 RUCKER 5%2Z <br />PLUMBING <br />ECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOWPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR CORD UNITS — H.P EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORYIWASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />_ <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />— <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />I <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.I <br />FIREPLACE INSERT <br />_ <br />HEAT PUMP <br />SUB TOTAL <br />f <br />SUB TOTAL 1 <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />S <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />-- <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />-YES (LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />E 2500.00 <br />38 <br />50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MA%. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES F'NO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />38 <br />50 <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />CL) <br />5. GRADING <br />6. DRAINAGE <br />]IDYAPPR. <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION FCC. BY <br />c <br />PLANS CHECKED <br />FOR ISSUANCE BY <br />db <br />ADDRESS FILE <br />p <br />