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The Ere <br />CITY OF <br />CC NSTRUCTION <br />F <br />everett PERMIT PERMIT NO.07311 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 ® COMBINATION ® BUILDING il MECHANICAL ® PLUMBING <br />OWNER MAIL ADDRESS C'Ti ZIP PHONE <br />Evergreen Medical Dental Building 3327 Colby 98201 259-3168 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />CLASS OF WORK <br />[]NEW <br />VALUATION OF WORK <br />S 7,000.00 <br />DESCRIBE WORK <br />remodel exist <br />❑ADDITION ALTERATION <br />ng residence <br />residence <br />LEGAL DESCRIPTION OF PROPERT' <br />L47-18 BLOCK 79101 <br />JOB ADDRESS <br />'4110 Wetmore <br />ATTACH <br />❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />I HEREBY CERTIFY THAT 1 HAVE: READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, <br />ALL PROVISIONS OF LAW$ AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTIN3 OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE JR LOCAL TAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT*0 CONTRACTOR OR AUTHORIZED AGEN DATE <br />f <br />X' hnTC�� �l%Pi 3/28/80 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />1 <br />WATER CLOSET (TOILET) <br />2 <br />OO <br />AIR COND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. CA <br />1 <br />LAVATORY (WASH BASIN) <br />2 <br />0O <br />BOILERS - H.P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS - TONNAGE EA. <br />1 <br />KITCHEN SINK 8 DISP. <br />2 <br />00 <br />FORCED AIR SYSTEMS - BS.U. M EA. <br />DISHWASHER <br />WALL HEATERS -BT.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - BT.U. M <br />1 <br />CLOTHES WASHER <br />2 <br />00 <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />nn <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE d CHIMNEY <br />_ <br />SINK (SERVICE - BAR, ETC.) <br />SUB TOTAL <br />8 <br />00 <br />SUB TOTAL S <br />2LOPERMITS <br />PERMITSTOTAL <br />FEE S <br />8 <br />0 <br />TOTAL <br />FEE S <br />2. <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />7311 <br />PLAN CHECK <br />FEE 20.00 <br />FEE <br />SITEVACAN <br />ONO <br />FEES <br />VALUATION <br />FEE <br />_ <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />1 <br />BUILDING <br />E 7,000. <br />40 <br />00 <br />SIZE OF BLDG. <br />Remodel <br />NO, OF STORIES <br />1 <br />MAX. OOC. LOAD <br />PLUMBING <br />8 <br />00 <br />FIRE ZONE 2 <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIREED <br />DYES XXO <br />MECHANICAL <br />2 <br />00 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1, ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC. <br />SCC. 3031a) <br />C <br />2. BUILDING PLANS <br />TOTAL <br />50 <br />00 <br />3. FIRE HYDRANT a <br />4. FIRE PROTEC(ION SYSTEM <br />PERMIT VALIDATION <br />WHEN�— 3 PROPERLY VALIDATED (IN THIS SPACE) THIS ISpYOUR <br />, PERMIT <br />O 8. 0 O 0249 j o y 0. O O —�• '� <br />cy <br />r <br />r <br />RECEIPT PT YOUR REGEtPT <br />U THANK YOU <br />„r6. GRADING j-, <br />'�6. DRAINAGE p <br />..7. ENVIR04M , AL IMPAM STATEMENT <br />B, HEALTH DISTRICT <br />PPLICAI A BY <br />,, JJ <br />c -o <br />CLANS CHECKED <br />I HM <br />l <br />AFPR.FORISSANCE.�Y' <br />A. JAM F E 3 1 v,R 8O <br />