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%I <br />i <br />D <br />The EY`iTYE'OOF r O NSTR U CTI O N <br />everett PERMIT PERMIT NO. 12820 <br />CITY HALL 2598745 <br />EVERETT• WA 93201 ❑ COMBINATION ❑ BUILDING 1Rk MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Patrick J. Fischer 2511 62nd Street Everett 98203 347-6628 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONT R AC OR MAIL ADDRESS CITY ZIP PHONE LICENSE ,. <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDP 5 CITY ZIP PHONE OCENSE E <br />PLUMBING CONTRACIOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />CLASS OF WORK <br />SXNEW ❑ AUDIT ON ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE Cl SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />VALUATION OF WONK <br />S <br />DESCRIBE WORE <br />Tna/a1T nnA cFmrc <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE REACT AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <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 S.'ATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGN URE OF CONTRACTOR OR 1,UTMORIZED AGENT GATE <br />X AWL4"ck 1.�, 12/15/83 <br />LFGAL DESCRIPTION OF PROPERTY SHOW BELOW O'I ATTACH FOUR GORIEST <br />LOT __ BLOCK —OF __ <br />-- <br />JOB ADDRESS <br />2511 62nd Street <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — N.P. EA. <br />EATHTUB <br />REFRIGERATION UNITS — H P. EA <br />LAVATORY(WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />_ <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS — B.T.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 />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />_rn <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />S <br />SUB TOTAL f <br />7 <br />50 <br />PERMIT <br />f <br />PERMIT f10 <br />TOTAL 1 EE <br />f <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT N0. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FINF ZONE <br />BASEMENT <br />FIRF SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />17 <br />50 <br />--- <br />OTHER <br />PENALTY <br />_ <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />U.B C <br />SEC 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />— <br />I7 <br />SO <br />3.FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION A, ��� r <br />WHEN PROPERLY VALIDATED (IN THIS �70 ) THIS �S PE�II�T—� (_� <br />CJ <br />VJ <br />I)IR RECEIPTO' <br />I i IN y ♦• O U <br />B. DRAINAGE <br />— <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />