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r- <br />lhn Ev <br />CITY OF W kI ST RU CTI O N <br />CITY OF <br />everett PERMIT PERMIT NO.10542 <br />CITY HALL 259 8745 IyV <br />EVERETT, WA 98201 El COMBINATION <br />COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER <br />NAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Herb Singleton, Jr. <br />1212 25th Street <br />Everett <br />9.8201 <br />252-8766 <br />ARCHITECT OR DESIGNI.R <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACT OR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE I <br />Everett Bldrs. Inc. <br />5606 Evergreen Way <br />Everett <br />98203 <br />353-7161 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />UCENSEP <br />EV ER EB <br />301PH <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE Y <br />CLASS OF WORN <br />❑NEW [-]ADDITION <br />❑ALTERATION l,�I�PAIR ❑DEMOLITION ❑FENCE <br />❑SIGN <br />❑GARAGE <br />VALUATION OF WORK <br />S 2500.00 <br />DESCRIBE WORK <br />Re -roof and gutters <br />- Composition <br />W <br />L <br />Single Family Residence <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />uT•61 o;LCc 558oF Everett <br />31-32 <br />1117 9rih Q*,..1. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRA OR OR AUTHORIZED AGENT DATE <br />x -y <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLCSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />KITCHEN SINK 8 DISR <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />_ <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR. ETC.) <br />SUB TOTAL <br />SUB TOTAL __ S <br />PERMIT S <br />PERMIT $ <br />_ <br />TOTAL FEE $ <br />TOTALFEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />s 2500. <br />38 <br />50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OW LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />❑YES ONO - <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U IC <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />38 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS IS YOUR PERMIT <br />2 3 6 t <br />Ln <br />U <br />YOUR RECE(PTT-1 <br />THANY IIV.0 <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. <br />=PLAN$Y <br />APPR. FOR ISSUANCE BY <br />J <br />