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the £rerkreen <br />�,T�°F ��-' �;ONSTRUCTI01��- <br />everett PERMIT PERMIT N0. � 6340 <br />CITY HALL 259�8745 <br />EVERETf, WA 98201 [� COMBINATIOA ❑ BUILpING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIIADDRE55 CITY ZIP PMONE � <br />IFSSIFV f.ONSTRIIf.TTQN ta�na Rpfholl E,yorett' HW�I � aatnaii wa qRntp <br />ARCMITECT OR OESIGM R MAIL n00RE55 GITY 21P PHONE <br />GENERALCONTRACTOR MAILADORE55 GITY 21P PHONE IICENSEN <br />�])f11P <br />MECMANICALCONTRACTOR MAILADDRESS CITY ZIP PHONE IICENSEI <br />PLUMBING CONTRACTOR MAIL AODflE55 CITY ZIP PHONE LICENSE 1 <br />� NEW O AD�ITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />f 50��0�.00 <br />�ESCFIBE WOFK <br />New single family residence <br />Single�family residence <br />LOT,_y� 6LOCK _OF <br />JOB ADDRE55 <br />141J — �ISL <br />PLUMBING <br />N0. TYPE OF <br />BATHTUB <br />LAVATORV�WASHBASIN) <br />SHOWEF <br />KITCHEN SINK 8 �ISP. <br />DISHWASHEFi <br />LAUNDRYTRAY <br />�_ CLOTHES WASHER <br />� WA7ER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADE <br />SINK (SERVICE -- BAR, ETC) <br />SUB TOTAL : <br />PERMIT S <br />TOTAL FEE S <br />: YAFD SETBACK S7REE7 SETBACK REAR Y/ RD 5 <br />' 20' 20' <br />ZONE LOT AREA VACANT SITE <br />_� XYES NO <br />E OF CONST. OCCUPANCY GROUP NO. OF DWEL <br />-N R-3 1 <br />i OF BLDG. NO. OF S70RIE5 MAX. OC4 LC <br />375 + 420 ? <br />APPpOVALS <br />1. ENVIRONMEN7AL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HV�RAN7 <br />4. FIRE PRO7ECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEME <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BV PLANS C <br />Sq S(j <br />REOUIRED <br />�YES .:NO <br />B� <br />�C <br />I HEREBY CERTIFY THAT I HAVE HEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIOhS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PqESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTL' OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE {�CONTpACTORQ(iAUTMORIjEDAGENT OATE <br />MECHANICAL <br />hIR COND. UNITS — H.P. I <br />REFRIGERATION UNITS — <br />BOILEPS — H.P. EA. <br />GAS FIPED A.C. UNITS -- <br />FORGED AIR SYSTEMS — <br />WALL HEATERS — B.7.U. <br />UNIT HEATERS — B.T.U. <br />EVAPORATIVE COOLERS <br />CLOTHES DHYERS <br />VENTILA710N FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIA <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB <br />86/16340 <br />FEES <br />BUILDING <br />FLUMBING <br />MECHANICAL <br />O7HER <br />PENAL7Y State <br />EA. <br />ME <br />�Gf� S � 7i <br />VALUATION <br />RECEIPT NO. <br />FEE <br />TOTAL + I I 3fi <br />PEHMIT VALIDATION <br />WHEN PROPERLY V0.LIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />ADDRESS FILE <br />1 150 <br />