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, - . <br /> � <br /> , � <br /> �heE°�,����„ � �`ONSTRUCTION - � <br /> CITY OF <br /> everett PERh�IT PERMIT NQ. O�H9H <br /> CITY HALL 259�8745 <br /> eveaert.wn eezai ❑ COMBINATION ❑ BUILDING � MECHANICAL PLUMBING <br /> OWNER MAILADDNE55 GIiY ZIP �N���� <br /> SOUTH 4IORN 4225 TERRACE DR. EVEETT 98203 252-7185 — <br /> pRC�uiECIOROCSiGNER MRILAD�RE55 GiTY �IP PMONE <br /> GEN[RRl LONTNACTOR MRII ADDRE55 CITY 21P PHONi IICCNSE� <br /> self PMONE IiCENSE/ <br /> MECHANICALCONTRACiOR MAILAODRE55 QTY ZIP <br /> PLUMOING CONIRACTOR MAIL PDDRC55 CITY ZIP PHONE LICCNSE I <br /> C1A550F\YORN <br /> ❑NEW ❑ACDITION ❑ALTERAiION []REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GAFAGE <br /> a <br /> VNIUFT�DN OF WORN <br /> S 10����� <br /> �ESCRIBE WORK <br /> RESIDE RESIDENC AND ENC7ASE CARPORT <br /> PForoseo use of euuoiNc <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> iEuatoescaivnoruoFvnoctetrrs�oweetowonnnncNrouacoPiEsi PUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ioT 4 eiocKl2—ov T,IAFR'PY�pII HERE NFOR NOWI THEEGRANTING OF A PERMITRDOESINOT <br /> PRESUME TO GIVE AUTHORITY i0 ViOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE LOCAL LAW REGULATING <br /> CONSTRUCTION OR TNE PERF M: NCE OF CONSTRUCTION. <br /> 51GNATl1PE0- NiRA ROFnU'�OFiZL AGEI OATE <br /> J09 ADORE55 ����Bp <br /> 4225 TERRACE DR. 'X <br /> PLUMBIN� MECM ICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WAiER CLOSET(TOILEI) AIF COND UNITS—N P.EA. <br /> REPRIG[9AilUN UNIiS—H.P.[A _. <br /> BATNTUB <br /> LAVATOPY(WASH BASIN) �OILERS—H P EA. <br /> — GAS HRLU A C.UNITS—TONNAGE EA. <br /> SHOWER <br /> KITCMEN SINK 8 D15P. _ �ORCED AIR SYSTEMS—B T.0 _ M EA <br /> WALL HEPTEF`--BT.0 M <br /> DISHWASHEF <br /> UNIT HEATEHS—B iL. �✓' <br /> LAUNDRVIRAY <br /> CLOTHES WASHER EVAP017�T��L COOLERS <br /> WATER HEATLR CLOTIi[S D^YERS <br /> VENTILAT�Gi PAN <br /> URINAI <br /> DRINKING FOUNTAIN RANGE HOOD <br /> AIP HANDLING UNIT— C.F M. <br /> FLO�R DRAIN <br /> VACUUM BR[AKERS STOVE <br /> ROOF DRAINS—RFINIEADERS METAI FIREPLACF.8 CHIMNEY <br /> SINK(SfRVICE—BAR,ETCJ <br /> SUBTOTAL SUB TOTAL f <br /> PERMIT f PERMIi i <br /> TOTALFEE f TOTALFEE f <br /> SIDE VARD SETBACN STREET SETBACK REAR VARD SEiBACK PLAN CHECK NUMI3ER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA �Y�S�T S,�N� FEES VALUATION FEE <br /> TYPE OF CANST. CCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING b 1000.00 0 0 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE 20NE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> ❑YES ClNO — — <br /> APPROVALS er DATE OTHE�. <br /> 1. ENVIRONMENTAL CHECK UST PENALTY U B C <br /> SEC.303(a) <br /> 2. BUILDING PLANS TpTp� LO OO <br /> 3. FIRC MYDRANT <br /> 4. FIRE PROTECTION SYSTEM PERMIT VALIUATION <br /> WMEN PROP[RLY VALIDAiED(IN iHIS SPACE)THIS IS VOUR PERMIT <br /> 6. DRA NIAGE 4 3 9 1 � V � O. O O �� � <br /> � <br /> 7. ENVIRONMENTALIMPACT9TATEMENT � <br /> 8. HEALTH DISTFICT ��O U R REC E I PP <br /> APPLICATION ACC.BY PLANS CH[CKED OV AAPN.FOR ISSUANCE BY � <br /> l (-�ANK YC.>U <br /> ADDRE55 FILE � '�' 8D <br />