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The Evergreen <br />CITY OFF C�ISTRUCTION <br />CITY <br />everett PERMIT PERMIT NO.08257 <br />CITY HALL WA A 98201 9-8 <br />EVERETT, El COMBINATION UOUILDING ❑ MECHANICAL El PLUMBING <br />01 <br />OWNER �AAIL ADDRESS CITY ZIP MUNI, <br />Vicki Jackson 1532 Colby 98203 259-2587 <br />ARCHIIECI OR CESIGNER MAIL ADDRESS CITY ZIP PONE <br />GENERAL CONTRACTO1 MULADDRESS CITY ZIP PHONE LICENSE <br />Everett Builders Inc. 5606 Evergreen Way 98203 353-7161 <br />MECHANICAL CONTRACTOR VPL ADDRESS CITY ZIP PHONE LICENSE F <br />EV ER EB 301PII <br />PLUMPING CONTRACTOR MAIL ADDRESS CRY i IP PHONE I ICENSE F <br />CL ASS OF VIO3K <br />❑NEW ❑ADDITION ❑ALTERATION Zii7EPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GAIAGF -- <br />VALUA71ON OF WORK <br />s 4805.00 <br />repair foundation <br />PROPOSED USE OF BUILDING <br />single family SMNNIX real.dence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DEKAIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR CO <br />2 3 Pinehurst Div. A <br />TYPE OF WORK WILL BE COMPI.!ED WITH WHETHER SPECIFIED <br />LOT PLOCK_OF <br />HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO. <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, <br />SIGNATUR'' Of OONTRACTO AUTHORIZE[ .ENT DATE <br />' <br />X 9 10 80 <br />JOB ADDRESS <br />2208 62nd Street <br />I 44A <br />PLUMBING <br />MECHANICAL <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILETj <br />AIR COND UNITS — H.P. EA <br />REFRIGERATION UNITS — H.P. EA <br />BATHTUB <br />BOILERS — H P. EA. <br />LAVATORY MASH BASIN) <br />GAS FIRED AC. UNITS —TONNAGE EA. <br />_ <br />SHOWEP <br />FORCED AIR SYSTEMS — B T.U. M EA <br />KITCH" SINK A DISP. <br />WALL HEATERS —BT.U. M <br />DISHWASHER <br />UNIT HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />WATER HEATER <br />VENTILATION FAN <br />URINAL <br />— <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />e.O MAMTtl 'In IINIT— CFM <br />SIDE YARD <br />— BAR. ETC) <br />SUB TOTAL <br />PERMIT ! <br />TOTAL FEE 9 <br />STREET SETBACK <br />REAR YARD 5 <br />LOT AREA <br />VACANT 61 FE <br />L1YES ❑NO <br />PERMIT <br />FEE I RECEIPT NO. <br />BUILDING <br />L 4805. <br />32 <br />00 <br />SIZE OF BLDG <br />NO OF STORIES <br />MAK. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASE+AENT <br />FIRE SPRINKLERS <br />MECHANICALREOUIRED <br />OYES LINO <br />_ <br />00 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />_ <br />T. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC <br />SEC. 303 (a) <br />_ <br />2. BUILDING PLANS <br />TOTAL <br />32 <br />3. FIRE HYDRANT <br />_ <br />f. PROTECTION SYSTEM <br />FIRE PROTE <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS 6PAU) THIS IS YOUR PERMIT <br />A .L <br />/ It O` <br />_ <br />5 GRADING <br />6 DRAINAGE <br />— <br />N <br />7 ENVIRONMENTAL IMPACT STA'LMENT <br />4::IUJANCE <br />0D <br />YOUR R L C E- I Pp <br />0. HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR SS <br />i HAI K YOU <br />+Y. ;1 <br />