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01 <br />the Errrcrrrn C O N ST R U CT I O" <br />everett PERMIT <br />CITY HALL 259 6745 <br />EVERETT, WA 96201 ❑ COMBINATION ❑ BUILDING XX MECHANICAL <br />PERMIT NO. 14759 <br />PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />Doug Meyer <br />4509 Seahurst Avenue <br />Everett <br />98203 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE N <br />MECHANICAL CONTRACTOR <br />MAR ADDRESS <br />CITY <br />ZIP PHONE LICENSE N <br />Natural Gas Equipment <br />1625 East Marine <br />View Drive <br />Everett 98201 258-2441 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P PHONE LICENSE N <br />ILn V1 .-1 ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />s <br />PROPOSED USE OF BUILDING <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 />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACHFOURCOPIESI <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT _ BLOCK -OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DAIF <br />4/24/85 r <br />JOB ADDRESS <br />4509 Seahurst Avenue <br />X I 1`�O <br />PLUMBING <br />MECHANICAL <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 - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - M.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS - M.P. EA. <br />GAS FIRED A.C. UNITS - TCNNAGE EA. <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <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 & CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />" <br />1 <br />ater Heater <br />- <br />SUB TOTAL <br />S <br />SUB TOTAL S <br />10 <br />PERMIT <br />S <br />PERMIT $ <br />no <br />TOTALFEE <br />$ <br />TOTAL FEE S <br />20 <br />150 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDS TBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />[:!YES 5NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$ <br />512E OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />• <br />20 <br />50 <br />REQUIRED <br />YES NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />U.B.C. <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC. 303(a) <br />2. BUILDING PLANS <br />TOTAL <br />20 <br />5Q <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED RN THIS SPACE) THIS IS Y1116ER106T <br />5.GRADING <br />LL,, <br />`0; <br />6. DRAINAGE'LL <br />7. ENVIRONMENTAL MPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />a <br />ADDRESS FILE <br />L_ <br />MI <br />