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�heEcer,Grrrn ,� �pNSTRUCTlO�. - <br /> C�lv O� � <br /> e�erett PER�IIT PERMI'f N0. 1� (� E <br /> CITV HALL 259�d745 <br /> EVERETT.WF�J8201 ❑ COMBINATION GS�JC BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWN`_R MAILFDDRE`.5 CITV ZiP PMONE <br /> Thorvald Hanson 10130 7th Avenue S.E. Everett 98203 353-3946 <br /> ARCMIIECT OR DESIGNER MAIL ADDRE55 GIiY 21P PMONE <br /> GENEPAL GONTRAGiOR MAR A�ORESS CITV ZIP PNONE LICENSE x <br /> Same <br /> MEGMANICAL CONTRAGTOR MAIL AOORE55 G7Y 21P PNONE LIGENSE� <br /> PLUMBING GONTRACTOR MAIL AOOflE55 CIiY 21P PNONE UGENSE R <br /> CLA55 OF WOPK <br /> ❑NEW �X�DDITION G ALTERATION ❑REPAIR ❑ DEMOLITION ❑ PENCE ❑ SIGN ❑ WOOU STOVHFIREPLACE IN <br /> VALUATION OF IVOHN <br /> S 2`J��.00 <br /> DESCRIBE WOR1( <br /> Attached car-port <br /> PROPOSEOUSEOF BUIL�ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS o <br /> sinqle family residence ApPLICATION AN� KNOW THE SAME TO BE TRUE AND .-{ <br /> LEGAL�ESGRIPiION OF PROPERiY(SHOW BELOVI OR ATfACM FOUR COCIE51 CORRECT. ALL PROVISIONS OF LAVaS AND ORDINANCES � <br /> 19 2 Broadway Farms GOVERNING THIS TYPE CF WORK WILL BE COMPLIED WITH m <br /> �or_e�ocK_or WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A �� <br /> PERMIT DCES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR -�+ T� <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE N= <br /> PERFORMANCE OF CON TRUCTION <br /> JOB AD'JRE55 SIGNFTURy{]F NCJJ 1F/CT�Rj1 A iHORI AGENT �ATE C O <br /> 10130 7th Avenue S.E. <br /> X �L�����s,•�c��j A1.r� tYSlCY1[�5/13/85 m o <br /> --�c <br /> PLUMBING MECHANICAL � m <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE = y <br /> - AIR COND.UNITS- H.P. EA. m <br /> W ATEF CLOSET(TOILEn `� <br /> f REFRIGERATION UNIiS - M.P.EA. '� Z <br /> BATHTIIB C <br /> LAVATORY(WASH BASIN� BOILERS - M.P. EA. r = <br /> GAS FIRED A.C. UNITS - T�NNAGE EA. � � <br /> SHOWER � N <br /> FORCED AIR SYSTEM$- 6.T.U. M EF. � <br /> KITCHEN SINK 8 DISP. � <br /> DISHIV>SHER WALL HEATERS- B.T.U. M _ -q 3 <br /> LAUNIiRY TRAY UNIT HEATEFS- B.T.U. M .-.� (ft ' <br /> -- EVAPOFiAT��E COOLERS = <br /> CLOTHES WASHER m tn <br /> WATER HEATEP. CLOTHES DRYERS O r <br /> VENTILATION FAN C� fn <br /> URINAL <br /> DRINKING FOUNTAIN HANGE HOOD 3 tNi� '� <br /> AIR HANDLING UNIT - C%M. _ �; i <br /> FLOOR DRAIN _, �— -{r- <br /> VACUUM BREAKERS S70VE- WOOD • m � <br /> - METAL FIREPLACE 8 CHIMNEY D � <br /> qOOF DRAINS- RAINLEADERS - � � <br /> SINK(SERVICE- BAR, ETC.) FIREPLACE INSER7 -1 I <br /> ='1 <br /> HEAT PUMP = , <br /> -i <br /> 2 � <br /> � <br /> SUB TOTAL 3 SU8 TOTAL S z ' <br /> PEfiMIT t C � <br /> — PENMIT S '— �-- .�-� ' <br /> TOTAL FEE S TOTALFEE : n <br /> pLAN CHECK FEE m � <br /> SIDE YAftD SETBA7ClK Ft STREeT SE�SACK REAR YARO SETBACK PLAN CHECK NUMBER RECEIPT NO �� <br /> 25 85/19946 FE�503 �a��- �6 9�6 <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> R-S �. YES N� <br /> � <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWfiLLING UtJITS <br /> V-N M BUILDING S 2600. 38 50 <br /> SIZE OF BLDG. NO.OP STORIES MA%.OCG LO,�A pLUMBING � <br /> 440 Sq. Ft. 1 _ <br /> FIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> FEOUIPED <br /> YES NO � <br /> OTHER <br /> APPPOVALS eY DATE — � <br /> U.B.C. <br /> L ENVIRONMENTAL CHECK LIST PENALTY SEC.30J(a) <br /> 2.BUILDING PLANS TOTA� 38 SO <br /> 3.FIRE HVDRANT <br /> 4.FIRE PROTEC710N SYSTEM PEHMIT VALIDATION - � <br /> WHEN PROPERLV VALIOATED QN TMIS SPACF)THIS IS YOUR BERMIT <br /> S.GRAOING ' � � � '�� <br /> 6.DRAINAGE � j <br /> 7.ENVIRONMEYTALIMPACTSTATEMENT � <br /> B.HEALTH DISTRICT � � � �� <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR. FOR ISSUHNCE BY <br /> EB tfi+iM LC � <br /> ADDRESS PIL;� � <br /> i <br />