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d�c Ll'erlrern <br />��,r�,o� <br />everett <br />CITY HALL 259�8745 <br />� - �'O�VSTRUCTlOIN <br />P�RMIT <br />PERNiIT N0. ���7� ? <br />EVERETT,VJA9B201 � COMBINATION � I3UILDING ❑ MECHANICAL ❑ PLUMBI�G <br />OWNER MAILAD�RESS CITY ZIP PHONE <br />C`HARTFS 7ASPFR 7415 — Rth G�'YPPY Everett WA 98201 252—$:�58 <br />nPCHIiEGT OR DESIGNER MAIL AODRESS CITV ZIP ?HONE <br />GENERAL CONTRAQOF MAIL qODRESS CITY ZIP PMO`!E LICENSE X <br />Same <br />MEGMANICAL GONTPACTOR MAIL ApORESS CITY ZIP PHONE UCENSE k <br />PLUMBING CONTFACTOR MAIL AODPE55 CITV ZIP PHONE UCENSE x <br />I� NEW ❑ AD�ITION $X ALTERATION ❑ REPAIFl ❑ DEMOLI710N ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACF. INSER7 <br />= 2000.00 _ <br />DESGRIBE WORK <br />Construct pitch roof over existing roof <br />Residence <br />EGFL DF.SCRIPTION OF PROPERTY BHOY! BELOW OR ATTAGY. FOIIR GOf'IES� <br />�oT 105 e�or.K_oF Legion Park Addn #2 _ <br />JOH ND�RE55 <br />2415 - Sth Street <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 D:SP. <br />DISHWASHER <br />LAUNDRYfRAV <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF'DRAINS — RAINLEAOERS <br />SINK ISERVICE — BAR. ETQI <br />SIDE YAqD SEl <br />USE ZONE <br />TVPE OF CON: <br />SIZE OF BLUG. <br />SUBTOTAL <br />PENMIT <br />TOTAL FEE <br />.EETSETBACK <br />DO.OF <br />BASEM <br />APPfiOVALS <br />t. ENVIRONMENTAI CHECK LIST <br />2. EUILDING PLANS <br />3. FIHE HVDRANT <br />4. Flflc PR.7TECTION SYSTEN <br />5. GRADING <br />6.DRAINAGE <br />7.LNVIRONMENTALIMPACTSTATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. <br />FEE <br />� <br />5 <br />S <br />REAR YAHD SETBACK <br />VACANT S!TE <br />YES NO <br />NO. O� JWELLING UIJITS <br />MA%.00C.LOFD <br />PIRE SPPINKLERS <br />REOUIRED <br />YES NO <br />BY DATE <br />CHECKED BY �APPR.FORISSUANCE BY <br />eb I jef <br />I HEREBY CERTIFY THAT � HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANGES <br />GOVERNING �THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER 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 REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNA E OF CON�. ^.CiOR OR aI1TMORIZED AGENT ONTE <br />X���Z C� �� 4/15/85 <br />ree <br />AIH"COND. UNITS — H.P. EA. <br />flEFRIGERA710N UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIREU A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL !1EATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VEN7ILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIRBPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />Sl1B iOTAL S <br />PERMIT S <br />TO7AL FEE 5 <br />PLAN CHEGK NUMBER YLHN GHtUK ttt <br />BS�].�I�].Z FEE 21.13 RECEIPT NO. <br />OZ$— <br />FEES VALUATION FEE <br />BUILDING I 5 _ _ _ <br />__��llll! <br />PLUM8ING <br />MECHANICAL <br />O7HER <br />F�NALTY U.B.C. <br />ScC.303 <br />TOTAL I I 3i I$O <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED pN THIS SPACE� THIS IS YOUR. PERMIT (� <br />_ _.-i <br />� <br />� <br />� <br />ADDRESS FILE <br />�� <br />