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rhe l:rerereen <br />��r�, �� <br />everett <br />CITY HALL 259�8745 <br />� �' �'ONSTRUCTIOh`�� <br />PER!�IIT <br />PERMIT N0. 16 3 iJ ' <br />EVERETT, WA 98201 � COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEfl MAILA�DRE55 GRY ZIP PMONE <br />Joe Bruner 9505 - 7th Ave. S.E. Everett 98204 355-5519 <br />APCMRECT OR OESIGNER MAII FDORES$ C'.TY 21P PMONE <br />GE, ERAL GONTRAGTOR MAIL A�DRE55 CITY ZIP PHONE LICENSE / <br />Branson United Steel 18023 Hwv. 99 Suite J Lvnnwood 98037 778-1116 <br />MECHANICAI CONTflAGTOF MFIL AO�RESS CITY LP PMONE UCENSE � <br />N/A BRANSI*214JK <br />PLUM6ING CONTRACTOR MAIL AODRESS CITV ZIP PHONE LICENSE x <br />N/A — <br />OF <br />S <br />C$NEW ❑ ADDITION ❑ ALTERATION ❑ REPAI(i ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />LOT__BLOLK_OF <br />tlJVJ � /l.11 HVC3ILLC J�1'a�• !]Vv—a <br />PLUMBING <br />NO. _TYPE OF FIXTURE OR ITEM <br />WATER GLOSET �TOILET) <br />BATHTUB <br />LP.VATORY (WASH BASINI <br />SHOWEfi <br />KITCHEN SIIdH 8 DISP. <br />DISHWASHER <br />LAUN�RYTRAV <br />CLO7HES WASHER <br />WATEFi HEATEP <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKEFS <br />ROOF DRAINS — RHINLEAOERS <br />SINK�SERVICE — BAR,E7C.) <br />SUBTO7AL <br />PERMI7 <br />70TAL FEE <br />SIDE YARD SETBACK STREE7 SETOACK <br />6' 20' <br />USE ZONE LOT AREA <br />x-i si,2oo s.r. <br />TYPEOFCONST. OCCUPANCYGROUP <br />v-N rt-1 <br />SIZE OF BLDG. NO. OF STORIFS <br />%2� S.r. �. <br />FIRE ZONE BAS[tdENT <br />APPROVALS _ <br />1. ENVIRONMENTAL CHECK LIST <br />2.8UILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PRO7ECTION SYSTEM <br />5. GRADING <br />6.DRAINAGE <br />7.ENVIR0I�MENTALIMPACTSTATEMENT <br />8. HEALiH DISTRICT <br />APPLICATIG!: ACC. <br />FOUR <br />I HEREBY CEFTIFY THAT � HAVE READ AND EXAI,AINED THIS <br />APPLICATION AND KNON1 THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVIS�ONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULA ING CONSTRUCTION OR THE <br />PERFC�RIofAyJCE OF,COjJ�TRUCjIQN. , <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILENS — H.P. EA. <br />GAS FIRED F.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL MEATERS — B,T.U. M <br />UNIT HEA7ER5 — B.1.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VEN7ILATION FAN <br />RANGEHOOD <br />AIR HANOLING UNIT — C.F.M. <br />STOVE — WOOD <br />ME7AL PIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />� <br />5 <br />5 <br />.EAR YARD SETBACK <br />20' <br />'ACANT SITE <br />YES }{NO <br />10. OF DWELLING U� <br />-0- <br />AAX.00C.LOAD <br />'IRE SPRINKLERS <br />IEOUIRED <br />YES NO <br />BY �ATE <br />CMECKED BV �APPR.FORISSUANCEBY <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />R6/16302 FEE �5.03 <br />FEES , VALUATION <br />BUIIDING S 24��_ <br />PLUMBING <br />MECHANICAL <br />O7HER <br />PENALTY U.B.G. <br />SEC.303 <br />5 <br />5 <br />S <br />rtt <br />RECEIP7 NO. <br />FEE <br />TO7AL I I 38 I 50 <br />PERMIT VALI�ATION <br />WHEN PROPERLY VALIDATED IIN THIS SPACEI THIS IS YOUfj PERMIT i;\ : <br />� . �' , � ,. - ��—r.�i <br />�... . <br />AfJf;h(S; FR� . . . <br />