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(hr£verxreen CaNSTRUCTlO� � <br /> Citv 0� � . <br /> everett PERMIT PERMIT NO. 15118 <br /> CITV HALL 259�8745 <br /> EVERETT,WA98201 Q COMBINATI�JN I]�t BUILDING ❑ MECHANICAL � PLUMBING <br /> OWNER MAIL AD�RESS CITY ZIP PHONE <br /> James L. Carison 2512 Sth Street Evere'ct 98201 259-4142 <br /> AFCHITECT OR OESIGNER MAIL AODRESS LITY 71P PHOHE <br /> GENERAL CONTRACTOR MqIL.ODORESS CITY ZiP PHONE LICENSE Y <br /> Same <br /> MECHANIGAL GOYTRACIOR MAIL AODRE55 LITY ZIP PHONE LILENSE N <br /> PLUMBING CONTRACTOfl MaIL AODRESS CITY ZIp PMONE I.ICENSE� <br /> CLASS OF WORN <br /> ❑NEW Q ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOc S70VE/FIREPLACE INSERT <br /> VALIIqTION OF WORK <br /> S 15��.�� <br /> DESCflIBE WORK <br /> 6'x20' foot addition <br /> PROPOSEO IISE OF BUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGAL DESCRIPTION OF PPOPEPTY�SHOW BELOW OR ATTACM GOUR COPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> 73 Legion Park CORRECT. ALL PROVISION£ OF LAWS AND ORDINANCES <br /> LOT__BLOCK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITFi <br /> WHETHER SPECIFIED HERE�N UA NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AU7HORITY TO VIOLATE <br /> — OR CANCEL THE PROVISIONS OF ANY OTHEF STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMA E OF CONSTRUCTION. <br /> JOBAOORESS SIGNATUREOF NiqACiOR AUTr ORIZEDAGENT OATE <br /> 2512 Sth Street X , ��/ <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSE7�TOILEn AIR COND. UNITS — H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— <br /> H.P. EA. <br /> LAVATOR`f(WASH BASIN) BOILERS— H.P. EA. <br /> SHOW[R GAS FIflEO A.C. UNITS— TONNAGE EA. <br /> KITCHEN SINK d DISP. FORCED AIR SVSTEMS— B.T.U. M EA. <br /> DISHWASHER WA�L HEATERS— B.T.U. M <br /> LAUNDRY TFAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEA7EN CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLIIJG UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE— WOOD <br /> ROOF DRAINS— RAINLEADERS METAL PIREPLACE 8 CHIMNEY <br /> SINK�SERVIC�— BAP, ETC.) FIREPLACEINSERT <br /> HEAT PUMP <br /> SUB TO7AL S SUB TOTAL S <br /> PEHMIT 5 PENMIT S <br /> TOTAL FEE S 70TAL FEE 5 <br /> SIDE YAR�SETBACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUM,BER PLAN CHECK FEE <br /> 6' 20' Z�� $5/15118 FEQ6.25 RECEIPTNO. <br /> USE ZONE LOT AREA VACANT SITE <br /> R-1 7800 SCj. Ft. � YES XA�� FEES VALUA;ION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO. OF DWELLING UNITS <br /> V-N R-3 1 eu�!oiNG 51500.00 25 00 <br /> SIZE OF BLDG. NO.OF STOFIES MA%.OCC. LOAD <br /> 6'x20' Add'n 1 N/A P�UMBING 4 �Q <br /> F�tiEZONE BASEMENT FIqE SPRINKLERS MECHANICAL <br /> FEOUIRED <br /> YES NG <br /> APPROVALS BY OATE �THER <br /> L ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> 2.BUI:DING PLANS SEC.30J lal <br /> 3.FIREHYORANT TOTAL 29 SO <br /> d.FIRE PROTECTION SYSTEM PEHMIT VALI�ATION <br /> 5.GRADING WHEN PROPERLY VALIDA7E0(IN THIS SPACE)TMIS IS YOUR PERMIT Q('j <br /> 6.�RAINAGE � � 0 �. O O �� 3 � ��� � O � J. 0 O �� � <br /> 7.ENVIRUNMENLALIMPACTSTA7EMENT <br /> B.HEALTH DISTRICT � � <br /> APPI.ICATION ACC.BY PLANS CHECKED BV APPR. FOR ISSUA YO U R REC E IPT � <br /> MM JEF Lc �� R �P,[CEIPT <br /> �`-' \FJk YOU 7HANK YOU <br /> Ao�R�sAUFJ�$5 2 3 aus 85 <br />