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the `�TYeOF C"`NSTRUCTION <br />everett PERMIT PERMIT NO. 06921 <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUMBING <br />OWNER MNL ADDRESS CITY ZIP PHONE <br />Danard Custom Homes P.O. Box 1947 Everett 98206 259-1001 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE• <br />❑NEW ❑ADDITION RIti-TERATION ❑REPAIR EIDEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />3,000.00 <br />BE WORK <br />Exterior and interior remodel <br />PROPOSED USE OF BUILDING <br />Office <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THR AP. <br />AND KNOW THE SAME TO BE TRUE AND CORP-CT. <br />ALI TYPE OF WORK GOVERNINGISIONS OF LAWS AND ORDINANCES l <br />WORK WILL BE COMPLIED WITH WHETHER S ECIF fu <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTIO THE PERF RMANCE OF CONSTRUCTION. <br />SC C RACTOR AUi nGENi DATE <br />X 11/8/79 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW eEtow OR ATTACH PouR COPIES)PLICATION <br />N§10' of Pkpk 32oF J.S. Sines Acre Tracts <br />JOB ADDRESS <br />3901 Smith Street <br />PLUMBING <br />HANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COIJD. UNITS — N.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY (WASH BASIN) <br />_ <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK 3 DISP <br />FORCED AIR SYSTEMS -- B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—D.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — BIT 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 />_ <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />I METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT $ <br />PERMIT f <br />TOTAL FEE S <br />TOTAL FEE S <br />_ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT N0. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />5 3,000.00 <br />24 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />REQUIRED <br />)YES <br />SPRINKLERS <br />❑NO <br />MECHANICAL <br />APPROVALS <br />RY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC. <br />SEC. 303(B) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />24 <br />00 <br />4. FIRE PROTECTION SYSTEM <br />5GRADING <br />. <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />Cn <br />YO-U R RECEIPT a <br />THANK YOU <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPEL FOR ISSUANCE BY <br />