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I <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING P MECHANICAL • PLUMBING <br />OWNER MAIL ADDRESS !il' PHONE <br />David Ra 2818 19th Street <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />;223-01-EV <br />.O <br />m <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Everett Builders 5606 Evergreen Way 353-7161 ER EB <br />z <br />1 PH <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />(S' m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />N) <br />Qtl <br />PERMIT CLASS <br />❑COMBINATION <br />®BUILDING []PLUMBING ❑ MECHANICAL <br />OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />g 9950.00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />reroof, enclose porch, -gutters - siding <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT 9-10 2 OF Reddy Land CO. 1St <br />BLOCK <br />_I <br />NO. <br />TYPEEQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />JOB ADDRESS <br />2818 19th Street <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />I <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />-- — <br />VENTILATION FAN <br />RANGE HOOD <br />NO, <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />S <br />1 <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />GAS. SYSTEM: NO iO OUTLETS <br />FLOOR DRAINS <br />I <br />SUB TOTAL S <br />1 <br />KITCHEN SINKS & DISP. <br />I <br />PERMIT S <br />BAR SINKS <br />TOTAL FEE S I <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CO NSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />ED OR ABANDONED FOR A <br />PERIOD OFCONSTRUCT120 DAYS AT ANY ION OR WORK IS TIME AFTER WORK 5 COMMENCED. <br />I HEREBY CATIO CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP <br />L <br />P LIGATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />11/3/78 <br />X - - <br />ROOF DRAINS - RAIN LEADERS <br />SHOWER BATHS <br />I <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS -ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />PERMIT <br />s <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SI"A <br />GNATURE OF O TRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />FEE _ <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNITS-OFDWELLING <br />I <br />BUILDING <br />$ 9950.00 <br />52 100 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUM. 7G <br />- <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REQUIRED <br />OYES ONO <br />MECHANICAL <br />I <br />—T <br />SPECIAL CONDITIONS: <br />OTHER <br />PENALTY <br />Sdb, 3031.) <br />TOTAL <br />52 100 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SYAC Y I V S R PERMI <br />�OV R 'RECEIAT,�; <br />CD <br />TlJJ�K Xf+1 u) <br />I i qq. <br />--- <br />- -- <br />APPLICATION ACC[PTkII HY: <br />Yl.ANS (]ILCRkD bY' <br />APPROVLD FOR WMANCE By <br />ADDRESS FILE <br />1 <br />