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�heE�•rr,creerr - - CON�TRUCTIOP, <br /> c�Tv oF � <br /> everett PERMIT PERMIT N0. 12317 <br /> CITY MALL 259�9745 <br /> EVERETT,VlA99".Ol ❑ COMBINATION ❑ Blh!.UING ❑ MECHANICAL �[PLUM5ING <br /> OWNER MAILPDOflESS GITY ➢P PMONE <br /> Fay Eriksen 1611 24th Street Everett 98201 252-4479 <br /> qRGHITEGT OF�ESIGNEP MAIL A��RE55 QTV ZIP PNONE <br /> GENERALGONiRAGTOR MAlLA00RES5 CITY ZiP PHONE LICENSE� <br /> MECMANIWLCONTRRCTOR MAILAO�RE55 CiTY ZIP PMONE L�CENSEM <br /> PWMBING CONTflRLTOR <br /> MRIL AOOPE55 CiTY 21P PHONE 4CENSE� <br /> Same <br /> 1 <br /> cuss oc woan <br />, O NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR O DEkOLITION ❑ FENCE 0 SIGN ❑ WOOD STOVEIFIREPLACE INSER <br /> VALUATION OF WORN <br /> f <br />�� �ESGRIBE WORN <br />� PPOPOSEO USEOf BOILDING � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TU BE TRUE AND <br /> LEGF.DESGNIPtION OF PROFERTY�SHOW 6ELOW OR ATiRCN FOUH COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITN <br /> �or_eiocn_oF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESIiME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE CONST UCTION. DATE <br /> JOBApDRESS SIGNA OFGONTR ROR[LT IZEOAGENT g�10/83 <br /> 1611 24th Street X ' <br /> PLUMBINQ MECHANICAL <br /> N0. TYPE OF FIXTUPE Ofl ITEM FEE NO. TYPE OF E�UIPMENT <br /> FEE <br /> WATERCLOSET�TOILET) AIR COND.UNITS—H.P.EA. <br /> BATHTUB REFRIGLRATION UNITS— M.P. EA. <br /> LAVATORY�WASH BASIN) BOILERS— H.P.EA. <br /> SMOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINKB OISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS—B.T.U. M <br /> LAUNDRYTRAV <br /> UNIT HEA"'ERS— B.T.U. M <br /> CLOTHES WASHER _ EVAPORATIVE COOLERS _ <br /> WATER HEATER CLOTHES DFYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAI FIREPLACE d CMIMNEY <br /> SINK(SERVICE— BAR,ETC.) FIREPLACE INSERT <br /> 1 Water Line Z QO _ HEAT PUMP <br /> SUB TOTAL 3 2 0 0 SUB TOTAL S I <br /> PENMIT S j J PERMIT f � <br /> 'iOTALFEE S TOTAL PEE f f <br /> PLAN CHECK FEE I <br /> SIDE YARD SETBACK b?REET ScTBACK REAR YARD SETBACK PLAN CHECK NUMBER FEE � RECEIPT NO. � <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> i;YES CNO <br /> TYPE OF CONST. OCCUPANCY GPOUP NO.OF�WELLING UNI'fS , <br /> i <br /> BUILOING S i <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING S OO <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECMANICAL <br /> REOUIRE� <br /> — �_,YES :_.NO <br /> BY DATE OTMER 1 <br /> APVROVALS U.B.C. � <br /> 7.ENVIRONMENTAL CHECK LIST PENALTY SEC.903(a) <br /> 2.BUILDINGPLANS TOTA� S OO <br /> J.FIRE HYDRANT <br /> 4.FIRE PROTECTION SYSTEM PEHMIT VALIOATION <br /> WHEN PROPERLY VALIOATED(IN iHl$$P�f�)THI��YQpg P{jiN�T ,r'J � <br /> S.GRADING 0 J Y U U U v <br /> � 6.DRAINAGE � � <br /> 7.ENVIRONMENTAL IMPACT STATEMENT <br /> B.HEALTHDISTRICT �':7UR RECEIPT, � <br /> APPLICATION ACC.BV PLANS CHECKED BY APPR.FOR ISSUANCE BV '��A N n Y O U <br /> � � IiIJG 0 S <br /> ADDRESS fILE <br />