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the eP�TY OF C`1hP ^,TRUCT'I0N <br />everett PERMIT PERMIT NO.08523 <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICIXL 0 PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Vicki Jackson 1532 Colhy Ave FVerett QA2oa 2Rq-2Sp2 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />Everett BUilders Inc ;AAA FVergrrrn Way aR2n'+ 19;l-'i]rT <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE 'ACENSE 1 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />1­ r^ ❑NEW []ADDITION ❑ALTERATION 6lgE?AIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION 0- WORK <br />f 2Rin On <br />DESCRIBE W'.HK <br />1-1-kaxlla- <br />PROPOSED USE OF BUILDING <br />Res ntiAl <br />- <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 />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. `HE 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 />SIG ryAT OF CON) R 0 A iNOR4[D I N DATE <br />X1 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATIAC14 FOUR COPIESI <br />.J ' <br />LOT 2 LOCK_3_GF <br />JOB ADDRESS <br />2208-62nd St. <br />PLUMBING <br />MEVHJINICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF E UIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS - H P. EA <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA <br />LAVATORY ASH BASIN <br />BOILERS - H P EA. <br />SHOWER <br />GAS FIRED A C UNITS - TONNAGE EA <br />KITCHEN SINK 6 DISP. <br />FORCED AIR SYSTEMS - B T U. M EA <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS -BT.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR hANDLING UNIT - C F.M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE - BAR. ETC) <br />SUBTOTAL <br />SUBTnTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />TOTAL <br />FEE II <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />)]YES FIND <br />FEES <br />VALUATION <br />FEE <br />_ <br />TYPE OF OONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDO. <br />NO. OF STORIES <br />MAX. ITOC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRED <br />[]YES []NO <br />MECHANICAL <br />APPROVALS _ <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />38 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPAC4I THIS IS rdR fVm 7 0 ^� <br />VU VU [L 7 77 <br />c% <br />p pp F- T- P LL' <br />cc <br />.I V"'N Y C' u C <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />fl. HEALTH DISTRICT-CCI`T <br />APPLICATION ACC. BY <br />PLANS CHECKED) BY <br />rAPPFE FOR ISSUANCE BY <br />- 5 iRiv b u <br />ADDRESS FILE <br />