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- , ' � . <br />� dleEl'^ITYeOF �` �A�RU� e IO� <br /> r <br /> C eve�ett ���M�T PERfJiIT NO. O�a1H <br />` qTY HALL 259�8745 <br />� EVC.RETT,WA 90201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMOING <br />� ov,Nea Maa nooNcss crzv ziP rnor.� <br /> biark S. York 1610 37th Everett 98201 252-4420 <br /> GH;,�UT[GT OR OESIGN[R MAIL ApDRE55 diY ZIP FIIONE <br /> Self <br /> f,ENERALCONTRACTOR MAI�ADURE55 QTY ZIP PHONE LIGENSE/ <br /> Self <br /> MECHANICAL CANTRACiOR MAIL ADDRE55 CITY ZIP PHONE UCENSE I <br /> r'LUA181NGGONTPACiOR MAILApUPE55 CITY Z�P PMONE LICENSEI <br /> 0.FSS OF WCRR <br /> ❑NEW I�ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIG�� ❑GARAGE <br /> VAWAT�Oh OF WORK <br /> + 1�0��.0� <br /> DESCRIBE WOPK <br /> Kitchen cabinets, sink ( �lumb) electric artition caalls <br /> Pii0PO5CD USE Of BUILDING <br /> Rental I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �ecnioeseniPnoNOFaaoPearrisr�owae�owoann�+c�+FouneoPiEsi PLICATION AND KNOW THE SAME TO BE TRUE AND CORReCT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or 1&2 giceK 25 oF Pridays First Addition TYPE OF WOAK WILL BE COMFLIED WITH WHETHEfi SPEGFIED <br /> HEREIN OR NOT. THE GRANTING OF N PERA"iT DOES NOT <br /> to Everett PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LUCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANC OF CONSTRUCTION. <br /> J0��DDRE55 SiGNAtUR6 F �JIDrtC R OR A HOf��ZtD a� [t�T �ATE <br /> ✓ <br /> �G10 37th <br /> X �+ � 4-2-80 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET QOILET) NIR COND UNITS—HP.EA. <br /> BATHTUB REFPIGERATION UNITS—HP.EA <br /> LAVATORY(WASH BASIN) dOILERS—H.R EA. <br /> SHGWER GAS RRED A C.UNITS—TONNAGE EA. <br /> - KITCHEN SINK 8 DISP. 2 OO FORCED AIR SYSTEMS—B T.U. M EA. <br /> . DISHWASHER �NALL HEATERS—B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS—B.�L. M <br /> CLOTHES WASHEfl EVAPORATIVF COOLERS _ <br /> WATER HEATER CLOTHES DRVERS <br /> UflINAL VENTILATION PAN <br /> DRINI<ING FOUNTAIN RANGE HOOD <br /> FLOOfl ORAiN AIR NANDLING UNIT— C F M <br /> VACUUM�REAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS h7ETAL FlREPIACE 8 CHIbWFY <br /> SINK ISEflVICE—BAR.ETC.1 <br /> SUBTOTAL SUFTOTAL S <br /> PEHMIT S 3 00 PEFIMIT S <br /> TOTAL FEE S S 00 TOTALFEE S <br /> SIDE YARD SETBAGK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> f]YES RNO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UN;TS <br /> V—N R-3 1 <br /> S¢E OF BLDG. NO.OF STORIES MA%.OCC.LOAO BUILDING S 1�000.00 10 00 <br /> PLUMBING S 00 <br /> FIHE ZONE BASEMEN7 FIRE SPRINKLERS <br /> 3 ❑ESIRE�O MECHANICAL <br /> APPROVALS BY DATE OTIIER <br /> 1. ENVIRONMENTALCHECKLiST PENALT7 UBC. <br /> SEC.303(a) `� <br /> 2. BUILOING PL1NS — <br /> 3. FIRE HYDRANT � . TOTAL 15 00 <br /> � 4. FIRE PFOTECTION SYSFEM PERMIT VALIOATION � <br /> WHEN PROPERLY VALIDATED pN THIS SPACE)7HI5 IS YOUR PER�M{IT <br /> 5. GRADING '� O ./ S H S O I U. O O ��� ' � <br /> � 6. DRAItSJ{GE r--� <br /> NZ ENVIR����TAL IMPl�S7ATEMEN7 � � '� <br /> �B. HEALYFCDI �oT p YOUR RECEIP� <br /> �oAPPLICATI�N`,�.BY PLANS CHECKED BV APPR.FOR ISSUANCE Bv �'U n �� <br /> o , � � �, �Nn Y.O U <br /> � ^� v.c. � , . <br /> c , <br /> �" - � ��t80 <br /> C� ,�aDDRESS rILE <br />� <br />