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, T T - ; - i-�. ,. <br /> �,��e,.«��e�° - '' �NSTRUCTlAN � <br /> CITY Of � > }� <br /> ��Te1'�� PERIlIIlT PERMIT NO. OH�.�� Z _ <br /> GTY HALL 259�6745 � `�� <br />', eveaerr.wn �azo� ❑ COMBINQTION � BUILDING ❑ �dECHANICAL ❑ PLUMBING` „ <br />� MAILADURE55 GrtY ZIP c` �HONE ` ' —J <br /> OWNER <br />' Ceferino N,oya 9218 lOth Avenue S .E . Everett 98204 " 795=9541 � <br /> PRCNII[CT OR p[SIGNCR MAIL AODRE55 QiY 21P PMONf _ � <br /> MAILADDfiE55 CItY ZIP N PHONE LIC[I15L1 <br />� GENERAI GOHiRACTOfi N <br /> Same <br /> ldECHi�NiG�L COIITFlFCiOR MAIL ADUFESS GIiY ZIP (v PHONE LIGENSE 1 <br /> PWM[11NGCONTRACTOF IdAILApDRE55 UiY ZIP PMUNE LICENSEY <br /> GLASS OF WORK <br /> ❑NEW ❑AODITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑S�GN GARAGE <br /> VALUqTION OF YlOFK <br />` S 050. �� <br />� <br /> i OESCRIBE WORN <br /> brick chimney, brick wall brick floor for metal fire lace <br /> FROPOSED USE OF BUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />' �ecn�oescaianor+oFaaoPearv�sNowee�owoRnrrnc��FouacoPies� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> E ��r o�a�oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> f HEFEIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> I PRESUME TO GNE AUTHORITY TO VIOLNTE OR CANCEL THE PRO- <br />� VISIONS OF Y OTHER STATE OR LOCAL LAW R�GULATING <br />! CONSTRUCTI N OR THE PERFOR ANCE OF CONSTRUCTION. <br /> I sicr ..ae oF e +rr+ncion or+nun+a _o ce r onte <br />�� �oenoon�ss , � L?LC?*L <br /> 9218 lOth Avenue S .E. <br />� PLUMBING MECHA CAL __ <br /> N0. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF EOUIPMEN7 FEE <br /> WATER CLOSET(TOILET) AIP COND.UNITS—hI.P.Ei�. <br />� REFRIGERATION UNITS—NP.EA <br /> BATHTU� <br /> LAVA7DRY(WASH BASIN) BOILEFS—H.P.EA. <br /> SHOWEfl GAS FlRED AC. UNITS—TONNAGE EA. <br /> KITCHEN SINK&DISR FORCED AIR SYSTEMS--B T.U. M EA. <br /> DISHWASHER WA�L HEATERS— 9 T.U. M <br /> LAUNDRY TRAY UNIT HEATERS—0 T.U. M <br /> CLOTHES WASHER EVAPORATNE COOLERS — <br /> WATER HEATER CLOTHES DHYERS <br /> URINAL VENIILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> ROOR DRAIN AIP NANDLING UNIT— C F.h1. <br /> VACUUM �REAKERS STOVE S O <br /> ROOF DFAINS—RAINLEADERS AfETAL FIREPLACE 8 CHIMNEY <br /> SINK�SEflVICE—BAR,ETG) <br /> SUBTOTAL <br /> SUBTO7AL S � <br /> PERMIT 5 PERMIT 5 3 OQ <br /> TOTAL FEE S TOTAL FEE 5 7 S O <br /> SIDE YARD SETBHCK STREET SETBACK REAR VARD SETBAGK PLAN CHECK NUMF3EF? PLAN CHECK PEE <br /> FE[ RECEIPT NO. <br /> USE ZONF LOT AREA VACANT SITE <br /> L1YE5 LINO PEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP KO.CF DWELLING UNITS <br /> BUILDING f 850. 16 00 <br /> SIZE OP BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT qE0U1RED KLERS MECHANICAL '] S O <br /> ❑YES ❑NO <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST pENALTY U.B.0 <br /> SEC.3�3(a) <br /> 2. 6UILDING PIANS TOTAL <br /> 3. FIRE HYDRANT 2 3 S O <br /> 4. FIRE PqOTECTION SYS7EM PERMIT VALIOATION � <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMiT <br /> 5. GRADING N <br /> 6. ORAINAGE 2 / �- Z $ 0 I 6. 5 0 -�i <br /> 7. ENVIRONMENTALIMPACT STATEMENi � <br /> B. HFALTH DISTRICT O <br /> APPIICATION ACC.BY PLANS CHECKED BY AP?R.FOR ISSUANCE BY , . i::.C• i I P I <br /> ' :' `,' " U <br /> � v.c. <br /> ADDRESS PIL[ � ) �'��'� � I � <br /> , <br /> r„ . <br />