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The Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 6745 <br />FV ER ETT. WA 9B201 <br />CONSTRUCTION <br />P1=RMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />i <br />OWNER MAIL ADDRESS III' PHONE <br />258-1763 <br />m <br />Hellen Jensen 4430 Seahurst <br />—PHONE-- LICENSE NO. <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />223 Ol <br />z <br />0 LI LB <br />Solie Builders 7514 Juniper Drive 353-2331 <br />3 <br />MECHANICAL CDNTRACTOR MAIL ADDRESS PHONE l.i C <br />GI <br />m <br />MAIL PLUMADDRESS PHONE LICENSE NO. <br />BING CONTRACTOR <br />1 <br />[- <br />PERMIT CLASS <br />OF WORK <br />❑COMBINATION <br />❑BUILDING ❑PLUMBING []MECHANICAL <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />❑DEMOLISH ❑FENCE ❑SIGN SWIMMING POOL <br />tlXAXAYAX 3,000 00 <br />!f• AID I� <br />5 - <br />DFSCRIBE WORK <br />Repair back porch and ;hange wood windows to alluminum sash <br />PROPOSED USE <br />MECHANICAL <br />OF ENERGY ELEC. <br />❑GAS ❑ <br />TYPE <br />LEGAL DEliC RIPTION OF PROPS RiY (SHOW BELOW OR ATTACH <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />FOUR COPIES) Maple Heights <br />AIR CONO. UNITS-H.P. EA. <br />5 <br />I-OT 17 BLOCK —OF <br />REFRIGERATION UNITS- H.P. EA. <br />BOILERS HP EA. <br />I <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />I <br />SPACE & WALL HEATERS - B.T.U. <br />JOB ADDRESS - <br />4430 Seahurst Ave, <br />UNIT HEATERS-B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />T— <br />PLUMBING <br />_ <br />VENTILATION FAN <br />.. <br />RANGE HOOD <br />I - <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />I <br />BATH TUBS <br />CLOTHES WASHER <br />S I <br />WATER HEATER <br />1 <br />FAQ BUILT FIREPLACE & CHIMNEY <br />DISH WASHERS <br />I <br />�_- <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />I <br />FLOOR DRAIN$ <br />SUBTOTAL S <br />KITCHEN SINK$ & UISP. <br />PERMIT S <br />BAR SINKS <br />TOTAL FEE 5 I <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONST RUC <br />RUOF DRAINS - RAIN LEADERS <br />SHOWER BATH$ <br />IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />SUSPENDED OR ABANDONED FOR A <br />SERVICE SINKS <br />CONSTRUCTION OR WORK IS <br />CON RUCTION O <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />SUMPS <br />- SEWAGE PUMP <br />URINALS <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALI. <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPL <br />WATER CLOSETS <br />I <br />WATER HEATERS -ELECTRIC <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />O(REO <br />GIVE AUTHORITY TO VIOLATE ORCA14 ELTI EPROVISI,ONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFOR CE OF CONSTR CTION. <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />12/28/77 <br />Z <br />x ( - <br />SIGNATUREOF HTRACTo O AUTH. AGENT GATE <br />PLAN CHECK FEE <br />PERMIT <br />9 <br />TOTAL FEE <br />WATER SERV ICE SIZE BLDG. SUPPLY SIZE, <br />SIDE YARD SETBACK STREET SETBACK REAR YARDSETBAC <br />ER <br />PLAN CHECK NUMBFEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />❑YES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONSI'. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />I <br />BUILDING <br />E 3, OOO OO <br />24100 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MA%.00C. LOAD <br />1 <br />PLUMBING <br />MECHANICAL <br />FIRE ZONE <br />BASEMENT <br />REQUI RINKLF.RS <br />R E OUIRED <br />❑YES ONO <br />1 <br />OTHER I <br />SPECIAL CONDITIONS. <br />PENALTY SEC. 300(a) I <br />2 IOO <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPS RI Y VAI.IDATEO (IN THIS SPACE) I HIS IS YO; R PERMIT <br />(OUR RCCEIP <br />THANK YOU' <br />0 <br />AM[ ICATIONP UPTUO BY <br />PLANS 04M6`_u by <br />nITHOYIn 1011 eSUANCI Nr <br />eb <br />29UK , <br />- <br />--¢ <br />- <br />Auur1CJJ "L_c. <br />m <br />