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theEvergreen rONSTRUCTION � � <br />GTY OF <br />�verett PERMIT pERMIT NO. 11270 <br />CITY HALL 259-8745 <br />EVERETf. WA 98201 ❑ COMBINATION ❑ BUILDING QxMECHANICAL ❑ PLUMBING <br />OWNER MNIIADpRESS CITV TIP PHONE <br />ROBERT G. LOVi 313 - 50t1i St. Everett WA 252-4975 <br />qRCHITECT Ofl DESIGNEP MAIL ApPRE55 CITY ZIP VHnuc <br />GENERFL CONTRACTOR MAIL AUORE55 CITY 21P PHONE UCENSE I <br />MECHANICAL OR MAILAD�RESS CITY 21P PMONE LICENSEI <br />Owner <br />PLUMBING CONTPACTOfl MAIL AD�RESS pITY ZIP PHONE �ICENSE 1 <br />+�NEW ❑ADDITION ❑ALTEiiATION ❑REPAIR ODEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />S <br />�ESCRIBE WOflN <br />Wood stove <br />PPOPOSED USE OF BUILDMG <br />Work shop <br />LEGAL DESGRIPTION OF PFOPERiY �SNOW BELOW OR ATTACN fOUR COPIES� <br />LOT BIOCK_OF <br />313 - 50th <br />PLUMBING <br />N0. TYPE OF FIXTURE OP <br />WATER CLOSET QOILET� <br />BATHTUB <br />LAVATORv (WASH 9ASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATLR HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DFAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK �SERVICE — BAR, ETG) <br />SU@TOTAL <br />PEqM1T <br />TOTALFEE <br />SIDE YARD SETBACK STREET SETBACK <br />USE 20NE LOi AREA <br />TYPE OF CONST. OCCUPANCY GRC <br />SIZE OF BLDG. NO. OF SiORIES <br />1. ENVIRONMENT�L CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDhANT <br />a. FIRE PROTECf10N SYSTEM <br />5. GRADING <br />6. ORAINAGE <br />7. ENVIRONMENTAL IMPACT STA7EMEN7 <br />8. HEALTH DISTRICT <br />APPUCATION ACC. BY PLANS CHECKED �Y <br />I HEREEY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <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 OiHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PEFFC•RMANCE OF CONSTRUCTION. <br />SIGNATU OFLONTRACiO'H0ORAUi RIZEDAGENi DATE <br />i� ��YfL4l� /l . _�iJ�Q_/ l � / 7 7/ O � <br />FEE <br />HEAR YAHD SETBACK PLAN ( <br />VACANT SITE <br />LIYES ❑NO <br />NO. OP DWELIING UNITS <br />BUILDI <br />MA%.00C.LOAD <br />PLUME <br />FIRE SPRINKLERS <br />REOUIRED MECHF <br />L7YE5 CiNO <br />BY DATE O7NER <br />PENAL <br />TOTAL <br />APPR, FON ISSUANCE BY <br />AIR COND. UNITS — <br />BOILERS — H.P EA. <br />GAS FlRED A.C. UNITS — <br />FOHCED AIR SVSTE�dS — <br />WALL HEATERS — B.T.U. <br />UNIT HEATEFS — B 1.U. <br />EVAPORATIVE COOLERS <br />VENTILATION FAN <br />AIR HANOLING UNIT — <br />M <br />M <br />C.F1d <br />FF.E <br />YALUATION <br />$ <br />U.B.C. <br />SEC.3031a1 <br />FEE <br />RECEIPT NO. <br />FEE <br />7 I 50 <br />WHLN PROPERLY VAL!DATED (IN iH15 SPACE) THIS IS YOUfl PERMIT <br />Permit No. 10851• gd s�tRy�e� � <br />tivas indicated on��4ica�tYBri•5fl ��� <br />but not typed on permit. N <br />t"'� <br />� . YOU�R RECEIPl'� <br />� •' iHANK YOU <br />. ;; . <br />ADDRESS FILE Y 2� gZ <br />1 <br />� <br />