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(he£vergreen ^ •-�,)ONSTRUCT101�1� � -� <br /> CITY OF pERMIT <br /> everett PERMIT NO. Og546 <br /> CITV HALL 259�8745 � COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> EVEFiEn.WA 98201 Z1P pNorve <br /> GITY <br /> MRIL ADLPE55 <br /> O\YNER EVERETT 98203 — �— <br /> GORDON BJORD 4914 23rd Ave. W• Z�P PHONE <br /> LITY <br /> MAIL AD�PESS <br /> ApCHITECT OR DESIGNF.R <br /> Z�P GNONE IICENSE Y <br /> CITY <br /> MAIL A��RESS <br /> GENERALWNTRAGTOR <br /> SAME Z�p PNONE UCENSEI <br /> MAIL ADDRESS <br /> GITY <br /> MECHANICAL CANTFACTOR �— <br /> Z,P PHONE LICENSE I <br /> MAIL ADDRE55 <br /> CITY <br /> PLUMBING CONSNnLTOR <br /> ClA55OF WORK <br /> [�NEW ❑ADDITIti?! ❑A�TERiTION ❑REPAIF7 ❑D[MOLITION ❑FENCE ❑SIGN ❑GA9AGE <br /> VPLUATION OF WORK <br /> S <br /> DESGR�OE WOPK <br /> pppPOSED USE OF BUILDINu I HEREBY CERTIFY THAT I HAVE READ AND EXAAAINED THIS AP- <br /> SINGLE FAMILY RES . pLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> LEGAL OE:JR�PTION OF PROPERiY(SMOW BELOW OR ATiACH FOUflCAFIES) ALL PROVISIONS OF LAWS AND ORDINANCES GOVERN�NG THIS <br /> GRANADA SEAVIEW ESTATi:S TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> ior 4 e��K—°F HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUMETO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTR�JCTION OR THE °ERFORMANCE OF CONSTR�U ETION. <br /> SIGNATU�E' F�AACTQF�OR AJiHORIZED AGENT 7/2 4�81 <br /> �� � � ) <br /> JO6 AODFE55 _ J(; <br /> 4914 23rd ave. W <br /> MECHANICAL FEE <br /> PLUMBING FEE NO. TYPE OF UIPMENT <br /> NO. TYPE OF FIXTURE OR ITEM qIR COND.UNIiS—H.P.EA. <br /> WATER CLOSE7(TOILET) REFRIGERATION UNITS—H.P.EA <br /> BATHTUB BOILEPS—H P.EA. <br /> LpVATORY(WASH 9FSIN) Gp5 FlPED A.C.UNITS—TONNAGE EA. <br /> SHOWER FOP"ED AIR SYSTEM' —B.T.U. M EA. <br /> KITCHEN SINK 8 DISP. WALL HEATERS—B?�U. M <br /> DISHWPSHER UNI7 HEATcRS—d.T.U. M <br /> LAUNDRY TRAY EVAPORATIVE COOLERS <br /> CLOTHES WASHER CLO7HES DRYERS <br /> WATER HEA7ER VENTILATION FAN <br /> URINNL RANGE HOOD �.F.M. <br /> DRINKING FOUNTAIN qIR HANDLING'JNIT— <br /> FLOOR DRAIN STOVE <br /> VACUUM BREAKF95 METAL FIREPLACE&CHIMNEY <br /> ROOF DRAINS—FIAINLFADERS <br /> SINK(SERVICE—BAR•ET��� <br /> SUBTOTAL S <br /> SUB TOTAL PEHMIT s <br /> PEflM1T s TOTAL FEE f <br /> . TOTAL FEE s PLAN CHECK PEE <br /> pEAR YARD SETBACH PLAN CHECK NUMBER RECEIPT NO. <br /> SIDEYARD SETBACK STREETSETBACK FEE <br /> VACANT SITE VALUATION FEE <br /> USE ZONE LOT AREA pYES ❑NO FEES <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS $ 166 S O <br /> BUILDING <br /> NO.OF STORIES MAX.OCC.�OHD <br /> SIZE OF BLOG. PLUMBING <br /> BASEMENT FIRE SPRINKLERS MECHANICAL <br /> FIFlE ZONE RE�UIRED <br /> pYES ❑NO <br /> BY pATE OTHER <br /> pppp0VAL5 U.B.C. <br /> t. ENVIRONMENTAL CHECK LIST <br /> PENALTY SEC.3031a) <br /> 166 50 <br /> 2. BUILDING PLANS TOTAL <br /> 3. FIRE HYDRANT pEpM�T VpLIDATION <br /> 4. FIRE PROTECTION SYSTEM WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS Y�UR PERMIT --� <br /> �' `; '' � � � jb. � � � <br /> 5. GRAC�NG � <br /> 6. DRAINNGE � <br /> 7. ENVIRONMENTAL IMPACT STATEMENi � ' I �� �Q <br /> B. HFALTH DISTRIGT • • '. - �� <br /> APPLI�ATION ACG BY <br /> PLANS CHECKED BY APPR.FOR ISSUANCE BY , <br /> i . ._ � I <br /> ADDRESS FILE <br />