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r <br />n14 <br />OR <br />L <br />the Evergreen -- JOIVSIT RUCTIOP' <br />CITY OF <br />everett PERMIT PERMIT NO. 12117 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Everett School <br />District #2 <br />Everett <br />98203 <br />342-7450 <br />AR'IHITECT OR CESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />CITY <br />ZIP <br />PHONE LICENSE <br />GENET4CONTRACTOR <br />MAIL ADDRESS <br />PHONE LICENSE <br />MECHANICAL LONIAACTOR MAIL ADDRESS CITY ZIP <br />Same <br />PLUMBING f.ORTRAGiO� MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />GLASS OF WORK <br />NEW ❑ ADDITION ❑ ALTERAToN ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑'AGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />S <br />PROPOSED USE OF BUILDING <br />I-iEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PPLICATION AND KNOW THE SAME TO BE TRUE AND <br />LEGAL DESCRIPTION OF PROPERTY (SHOP( BELOW OR ATTACH FOUR COPIES) <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING -THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT -BLOCK -OF-- -- <br />WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHOR;TY TO VIOLATE <br />-- <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />_ <br />LOCAL._ REGULATIy.G--C101JSTRUCTIGN OR THE <br />PER ORMAN OF CONSTRUUCCT"PON. <br />JOB ADDRESS b <br />�IGNATUR=OF C /AAcJO AUTHORIZ AGENT GATE <br />/ 6/22/83 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR IT <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE _ <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. F.A. - <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />SHOWER <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />KITCHEN SINK& DISP. <br />WALL HEAT ERS—B.T.U. M <br />DISHWASHER <br />UNIT HEATERS—B.T.U. M <br />LAUNDRYIRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />WATER HEATER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />.— <br />URINAL <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />FLOOR DRAIN <br />VACUUM SPEAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEAOERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />_ <br />HEAT PUMP <br />r A C P": <br />-10H9- <br />SUB TOTAL f <br />SUB TOTAL <br />11 no <br />PERMIT f <br />PERMIT f <br />On <br />TOTAL FEE f <br />21 00 <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CM F.CK NUMBER <br />FLAN <br />CHECK FEE <br />VACANT SITE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />— FEES <br />VALUATION <br />FEE <br />:.YES :,NO <br />NO. OF DWELLIN., -AITS <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />BUILDING <br />f <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MA%. OCC. LOAD <br />" <br />PLUMBING <br />FIRE ZONE BASEMENT <br />KLERS <br />MECHANICAL <br />21 <br />00 <br />RECUSPRI <br />YES NO <br />OTHER <br />APPROVALS <br />BY DATE <br />U.B.C. <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />21 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN T flA§E) THIl y((( L1U� RfTIT <br />5. GRADING <br />�7 <br />C\. <br />YOUR RECEIPT'" <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION AC.^,. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BV <br />THANK YOU <br />ADDRESS FILE <br />22AN83 <br />1 <br />J <br />L <br />J <br />