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theG'vCITYOF <br />_ Cr "NOSTRUCTION <br />�- <br />CITY OF <br />- 1-1 <br />everett <br />PERMIT <br />PERMIT NO.06342 <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 <br />❑COMBINATION il BUILDING El MECHANICAL <br />El PLUMBING <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />1st premium Homes 221 South Broadway <br />98204 <br />353-5080 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE/ <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE# <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR El DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK 6( 1 <br />S 10,000 ,91. Yds. fill <br />PROPOSED USE OF <br />LEGAL UESCRIPTIDN OF PROPERTY ISHOV! BELOW OR ATTACH FOUR COPIES <br />LOT BLOCK -OF <br />SW1a NW4 of SW� 17-28-5EWM <br />JOB ADDR S <br />9 05 19th Avenue S.E. <br />PLUMBING <br />I 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 />CO UCTION OR THE PE ORMANCE OF CONST <br />SI ATU : OF CANT Z D DATE <br />A,, _ _ _ &$&g%SX <br />u <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (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 DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - 8 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 />VFNTH ATITIN FAN <br />FLOUR CHAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />_ <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK ICFRVN•.F -PAP FTr 1 <br />PERMIT $1 <br />1 <br />1 <br />PERMIT f <br />TOTAL FEE $I <br />I <br />I <br />TOTAL <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />79/ <br />FLAN CHECK <br />! <br />FEE aO <br />FEE <br />R/EC`EIPTT ENOT�3 � 3 <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 />$10,000 <br />132 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />EYES ❑NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILD,NG PLANS <br />3, FIRE HYDRANT <br />TOTAL <br />132 100 <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />9326 :13 7.0 0 --.4a .14 <br />M <br />(a <br />Y0;0431 R E'CE i PT o <br />S. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE 1 7 .a�. 79 <br />