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the : vergraen <br />C r7 nF <br />everett <br />^ONSTRUCTION <br />PERMIT <br />PERMIT NO. 10526 <br />CITY HALL 259.8745 <br />❑ COMBIN %TION aBUILDING <br />❑ MECHANICAL El <br />PLUMBING <br />EVERETT. WA 98201 <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />OWNER <br />LDS Church <br />9509 19th Avenue <br />S.E. Everett <br />98204 <br />259-9314 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRB5 <br />CITY <br />ZIP <br />PHONE <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE III <br />GENERAL CONTRACTOR <br />Same <br />MECHANICAL OONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE - <br />ZIP <br />PHONE LICENSE 1 <br />MAIL ADDRESS <br />CITY <br />PLUMBING CONTRACTOR <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION .�ENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />$ 21000. <br />DESCRIBE WORK nnI ..F AI nhain link <br />Install Satellite rece4 voa aau -- <br />-- - <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />church <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVEI:NING THIS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES- <br />TYPE OF WORK WILL BE COMPLIED WITH WHET, IER SPECIFIED <br />LOT BLO K_OF <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 />SIGNATU CONTRACTOR OR i bR A -NT DATE <br />JOBADDRE S <br />9?09 19th Avenue S.E. <br />M°CHA <br />ICAL <br />PLUMBING <br />OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />NO, <br />TYPE OF FIXTURE <br />AIR COND. UNITS — M.P. EA. <br />WATER CLOSET (TOILET) <br />REFRIGERATION UNITS — H.P. EA <br />- <br />BATHTUB <br />BOILERS H P. FA. <br />LAVATORY 6VASH BASIN) <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 HEATERS —BT.U. M <br />DISHWASHER <br />UNIT HEATERS--B.T.U. M <br />— <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />WATER HEATER _ <br />VENTILATION FAN <br />URINAL <br />RANGE HOOD <br />AIR HANDLING UNIT —G.F.M. <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />STOVE <br />VACUUM BREAKERS <br />METAL FIREPLACE 8 CHIMNEY <br />ROOF DRAIN! — RAINLEADERS <br />SINK (SERVICE — BAR, LTC.) <br />SUBTOTAL $ <br />SUB TOTAL <br />PERMIT : — <br />PERMIT <br />f <br />TOTAL FEEi <br />TOTAL FEE <br />S <br />REAP, YARD SETBACK <br />PLAN CHECK: NUMBER PLAN CHErY FEE <br />STREET SETBACK <br />SIDE YARD SETBACK <br />VACANT SITE <br />OYES ❑NO <br />82/1052ei FEE 21.13 RES61Pjt0� <br />FEES VALUATION FEE <br />USE ZONE <br />LOT AREA <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />MAX. OCC. LOAD <br />BUILDING S 2,000. 32 $D <br />-- <br />SIZE OF BLOG, NO. OF STORIES <br />PLUMBING <br />FIFE ZONE BASEMENT <br />FIRE SPRINKLER. <br />REQUIRED <br />MECHANICAL <br />nYES ❑NO <br />APPROVALS <br />BY DATE <br />OTHER <br />1. ENVIRONMENTAL CHECKLIST <br />PENALTY UBC <br />.,EC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL 32 50 <br />3. FIRE HYDRANT <br />— <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS IS YQUOR QMIL <br />Qi S GJ <br />L L 3 4 <br />5. GRADING <br />N <br />6. DRAINAGE <br />7, ENVIRONMENTAL IMPACT STATEMENT <br />YOU pE^f•.Fpl'p <br />1`y. 4.6 <br />8 HEALTH DISTRICT <br />BY TH Ali ifOU <br />APLANS CHECKED BY <br />PLICATION ACC. 2Y P <br />APPR. FOR ISSUANCE <br />DAB <br />DAB <br />_ <br />no <br />ADDRESS FILE <br />