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the Evergreen C'n�T <br />CITY RUCTION <br />� <br />CITY OF <br />everett PERMIT PERMIT NO.08523 <br />CITY HALL 259-Bt45 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL El PLUMBING <br />MML AUOnFsS <br />CITY <br />LIP <br />IawNF <br />OWNER <br />MAIL AOORESs <br />CITY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />Everett BUild0ra <br />Tnc_ 5606yvergrann <br />WAv 9R20'1 <br />CITY <br />iS1-71 <br />ZIP <br />aT <br />PHONE <br />LICENSE F <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE / <br />MECHANK AL CONTRACTOR <br />MAIL ADDRESS <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE F <br />PLUMBING CONTRACTOR <br />CLAM OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION 61QEPAIR ]DEMOLITION ❑FENCE ❑SIGN OGARAGE <br />VALUATION OF WORK <br />f <br />OESCRIBE WORK <br />S v <br />'—w`E <br />PFIOPOBED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP, <br />Reeidenti al <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS LAWS AND ORDINANCES GOVERNING THIS <br />LE 1AL DESCRIPTION OF PROPERTY (SNOW BELOW OR ATTACH FOUR CO%ESL <br />nt <br />. <br />L BE COMPLIED WITH WHETHER SPECIFIED <br />TYPE OF WORK WILL <br />LOTJI_BLOCFt�_OF pin hurAr <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 />CONST UCTIO OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGfIAT OF CONT O A THORIZED A N DATE <br />1 <br />A)0 ADDRESS <br />,� <br />X <br />2208-62nd St. <br />ME N <br />NICAL <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT FEE <br />Al!COND. UNITS — H P. EA <br />WATER CLOSET (TOILET <br />R'.FRIGERATION UNITS — M.P. EA <br />BOILERS — H P EA. <br />BATHTUB <br />LA'/ATORY ASH BASIN <br />GAS FIRED A C UNITS —TONNAGE EA <br />SHOWER <br />FORCED AIR SYSTEMS — B.T U. M EA <br />_ <br />KITCHEN SINK 6 DISP. <br />WALL HEATERS —0T. 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 HFATER <br />VENTILATION FAN <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />ALL HANDLING UNIT — C F M <br />FLOOR DRAIN <br />VACUUM BREAKFRS <br />STOVE <br />ME1AL FIREPLACE 6 CHIMNEY <br />ROOF DRAINS — RAINLFADERS <br />R <br />SINK SERVICE — BAR. ETC. <br />SUB TOTAL f <br />SUB TOTAL <br />PERMIT f <br />PERMIT <br />f <br />TOTAL FEE f <br />TOTAL FEE <br />SIDE YARD SETBACK STREET SETBACK <br />f <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />LlYES [7N0 <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. DOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />[]YES []NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />T. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC <br />SEC 3031A1 <br />2. BUILDING PLANS <br />TOTAL 38 50 <br />3. FIRE HYDRANT <br />A FIRE PROTECTION SYSTEM <br />WHEN PROPERLY VALIDATED (IN THIS 1 HIS IS RY_M <br />PERMIT VALIDATION �f fU . O _— <br />5 GRADING <br />B. DRAINAGE <br />Lr <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />j p RECEIPT C C I PT <br />I\C C F <br />C <br />'� i AN \ E �/ O U <br />B. HEALTH DISTRICT <br />FOR ISSUANf" BY <br />APPLICATION AOC BY PUNS CHECKED BV <br />APPR. <br />. <br />