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r <br /> _ � <br /> r <br /> � <br /> `,,`. `"."+r`.¢`.,' ' CONSTRIlCTIO" <br /> eve�»�1.1. PERI��IIT RERMIT NO. 1�565 <br /> CITY MALL 259�B7d5 <br /> EVERETT.WA 96201 ❑ ,^OMBINATION K� BUILDING �� ME!HANICAL ❑ PLUMBING <br /> T Ol9NER MAILA��RE55 C�IY 21P PHONE <br /> JOI�V DAVIS 1416 - 25rd Everett i�'A 98201 653-1364 <br /> ARGNrt[Gi Ofi DESIGNEN MRIL AODRESS CITY ZIP PMONE <br /> GENERALGONiRACTOfi MAILAUO4E55 CIiY ZIP PMONE IICENSE� <br /> TFD2EE LAKES CONSTRLI;,TION 6523 - 171st Avenue SE Snohomish lVA 98290 568-4616 <br /> MEGNANiCAL GONTqAC10R MAi:ADDFE55 ��TY ���C�,CZOLP4 P���E ��CEN56� <br /> � PWMBING GONTFACTOfl IAAIL A�ORE55 GiY ZIP PNONE LI.ENSE I � <br /> CLASS OF WORN <br /> ❑NEW O ADOITION ❑ ALTCRATIOP' R�FiEPAIR ❑ �EhtOLITION ❑ FeNCE O SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> S 11��.0� <br /> pESCRIBE WORN <br /> Chip Rehap <br /> PROPOSED UFE OF BUILDING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALOESCRiPiIONOFPROPEdTY�SHOWBELOWGr.nTiAGMFOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINPNCES <br /> �0.3],�j��ocn.�B$_oF FVPYPYY GOVERNING THIS TYPE OF WORK WIL�_BE COMPUED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE G�3ANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIUNS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ApORE$S SIG F GONTfl>7TOH OA AUTHORRED GENT ORTE <br /> 1416 - 23rd X " ' � 10/18/83 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) AIR COND.UNITS— H.P.EA. _ <br /> BATHiUB REFRIGERATION UNITS—H.P.EA. <br /> LAVAIORY IWASH BASINI BOILERS— H.P.EA. _ <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. _ <br /> NITCHEN SINK 8�ISP. FORCEO AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRYTRAY UNIT HEATERS— B.T.U. M _ <br /> CLOTHES WASMER EVAPORATIVE COOLERS _ <br /> WATER MEATER CLOTHES ORYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE MOOD <br /> FLOOR DRAIN AIH HAN�LING UNIT— C.F.M. _ <br /> VACUUt+I BREAKERS STOVE—WOO� __ <br /> ROOF�RAINS— R.1INLEAOERS METAL FIREPLACE 8 CHIN�NEY <br /> SINK(SERVICE— BAR,ETC.1 FIREPLACE INSERT ___ <br /> HEAT PUMF _ <br /> SUBTOTAL S SUBTOTAL f _ <br /> PEflM�T S PERMIT S _ <br /> TOTAL FEE f TOTAL FEE f � <br /> SIDE YARD SETBACK 5'fREET SETBACK REAH VARD SETBACN PLAN CHE�K NUMBER PLAN CMECK FEE <br /> pEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> .YES NO --1— <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING UNITS <br /> BUILOING E1100.00 L <br /> SIZE OF BLOG. N0.OF STORIES MAX.OCQ LOAD <br /> PLUMBING <br /> L FIRE ZONE BASEMENT FIRE SPRINKLERS M� ;HANICAL � <br /> REOUIRED . _ <br /> YES NO <br /> APPROVALS BY DATE OTHEH __ <br /> 1.ENVIFONMENTAL CH�CK UST PENALTV U.B.C. <br /> SEC.?09�n� _ <br /> 2.BUILDING PLAhS <br /> TOTAL <br /> 3.FIflE HYDRANT <br /> L d.FIREPROTECTIONSYST�M PERMITVALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(W TMI��P�C�)THIS��Y�U�P�Rj�IIT �,(� <br /> � a « k <br /> 6.UMl.i7lAliE �_'� <br /> 7.ENVIRONMENTAL IMPACT STATEMENT �:�,j <br /> 8.HEALTH DISTRICT ��'.i �J R P.E C[i PT � � <br /> APPLICATION ACC.BY PLANS CHE�KED UY APPR.FOR ISSUANCE BY <br /> �;�;-�fi�i�1K YOU <br /> � goct83 <br /> ADL'�RE55 fIL[ <br /> � <br /> J <br />