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r <br /> 1 <br /> r <br /> -1 I <br /> 3"QNSTRUCTION <br /> everett PERMIT PERMIT NO. 11397 <br /> f CITY HALL.'59b[-V, <br /> 1 EVERETT.WA BB201 ❑ COMBINATION Ig BUILDING MECHANICAL ❑ PLUMBING <br /> OWNER MAIL ADEIK SC Ul, jII' NIONE <br /> F. J. Van Roeyen 2208 60th Street Everett 98203 353-4871 <br /> ARCHITECT OR DESAINEI MALL ADDRESS an :.IP NONE <br /> GENERAL('ONTfuCTOR MAIL ADDRESS Gn ZIP PONE 0iSE P <br /> Everett Builders Inc. 5606 Evergreen Way Everett 98203 353-7161 <br /> r MECHANICAL CMNTAACTOR MAIL ADDRESS CITY ZIP PIONE LICENSE F <br /> EV ER EB 301 PH <br /> NUMBING CI NTRACTOR MAR ADDRESS CI+Y ZIP NONE IY:ENSE0 <br /> CLASS OF NgRII <br /> L INEW 'D ADDITION ❑ALTERATION XkIREPAIR ❑CEMOLITK)N ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WO.I t <br /> E 3633.00 _ <br /> DESCRIBE MORA <br /> re-roof composition <br /> PROPOSED USE OF BUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> LEGAL DESCRIPTION OF PiOPEitt(SHOW BELL A OR AT TACO FOUR COPIESI PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 1-2 1 Pinehurst Div. A ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> LOT ela�GF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS IIIANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONS <br /> TR TION 0 E PERFORMANCE OF CONSTRUCTION. <br /> -- SI(x1ArunCONFMCT AUTHORIZED + DATE <br /> JOB ADDRESS <br /> 2208 60th Street X 1/6/83 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO.I TYPE OF EOUIPMENT FEE <br /> _ WATER CLOSET POILE11 AIR GOND.UNITS—WP,EA <br /> _ BATHTUB REFR'.IERATION UNITS—H P EA — <br /> L\VATORY ASH BASIN BOILERS—H P.EA. <br /> SHOWER GAS FIRED A .UNITS—TONNAGE EA <br /> KITCHEN SINK A DISP FORCED AIR SYSTEMS—B T U M EA — <br /> DISHWASHER WALL HEATERS—B T U. M <br /> LAUNDRY TRAY UNIT HEATERS—B T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR BRAN AIR HANDLING UNIT— CFM _ <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE S CHIMNEY <br /> SINK SERV'CF—BAR.ETC I <br /> SUBTOTAL SUBTOTAL f <br /> PERMIT S PERMIT <br /> TOTAL FEE S TOTAL FEE I <br /> i <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> AYES INO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP 19 OF DWELLING UNITS <br /> BUILDING $ 3633. 44 50 <br /> SIZE OF BLDG NO.OF STORIES MAX DCC LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE RFED KLERG <br /> EOU MECHANICAL J <br /> AYES [!NO <br /> APPROVALS BY DATE OTHER <br /> 1 ENVIRONMENTAL CHECK LIST PENALTY U.BC. <br /> SEC.303(A) <br /> 2. BUILDING PLANS <br /> TOTAL 44 50 <br /> 3 FIRE HYDRANT <br /> L A FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED LIN THIS SPACE)THIS 18 YOUR PERMIT L <br /> 5 GRADING <br /> B DRAINAGE 19 2 Z $044.50 <br /> ---- OV <br /> 7. ENVIRONMENTAL IMPACT STATEMENT Cy') <br /> t � <br /> S HEALTH DISTRICT YOUR RECEIPT <br /> APPLICATION ACC BY PLANE CHECKED BY APER FOR ISSUANCE BY <br /> THANK YOU <br /> .1 j <br /> ADDRIESS FILE 1 JAN a3 <br /> � J <br />