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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598 1' 5 <br />EVERETT. WA 98201 <br />^.ONSTRUCTION <br />PERMIT <br />❑ COMBINATION NKBUILDING CJ MECHANICAL <br />PERMIT NO. 09840 <br />❑ PLUMBING <br />OWNLH MAIL ADUNLSS U1T ZIP IIIUN1 <br />Dennis Dudder 2518 62nd Street Everett 98203 355-6508 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP RKINE <br />GENERAL ODNTRACTOR MAIL ADDRESS CITY ZIP RIONE LICENSE E <br />Same <br />MEOHANIM CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />PLUMBING COUIRAROR MAIL ADDRESS CITY ZIP RIONE LICENSEE <br />❑NEW k�tDDITION OALTERA71ON ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑LTARAGE <br />VALUATION OF WORI( <br />s 8,000.00 <br />DESCRIBE WORK <br />901A.1..101 BAAi 4i..n 4n of afin aE Ann nn <br />PROPOSED USE BE BUILDING <br />Single Family Residence <br />IHEREBY CERTIFY THAT IHAVE 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 DESCRIPTION OF FR IPLPIY ISHOW BELOW OR ATTACH FOUR COPIESI <br />Single Family REsidence--Replat <br />of <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT RLOCV OF <br />27 Pinehurat <br />Div. A <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 />CONSTR CTION OR THE PERF . ANCE OF CONSTRUCTION. <br />SIGNAL 0 CONTRACTOR OR AVTHOPN D ENi DATE <br />.LOB ADOPESfi <br />2518 62nd Street <br />X <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 GONG. UNITS- H P. EA, <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA <br />LAVATORY (WASH BASIN) <br />DO RS - H.P. EA. <br />SHOWER <br />GP 9RED AC. UNITS -TONNAGE EA, <br />KITCHEN 61NK S DISP. <br />2 <br />An <br />FC :ED 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 />_ <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />2 <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C F M <br />50 <br />VACUUM BREAKERS <br />STOVEWood7 <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE - BAR. ETC. <br />SUB TOTAL <br />SUB TOTAL <br />7 <br />50 <br />PERMIT <br />! <br />PERMIT S <br />TOTAL FEE <br />S <br />6 <br />O <br />TOTAL <br />FEE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />81/9840 <br />FEL44 53 <br />RECEIPT No. <br />55405 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />LIVES ONO <br />FEES <br />VALUATION <br />FEE <br />TYpE OF CONST. <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />V-N <br />R-3(Addition <br />1 <br />BUILDING <br />$8, 000. <br />68 <br />50 <br />SIZE OF BLDG <br />NO. OF STORIES <br />MAX OOC. LOAD <br />L59 Sq. Ft. Add <br />1 <br />PLUMBING <br />6 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />SPRINKLERS <br />MECHANICAL <br />7 <br />50 <br />I )YES <br />XXO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC 3071e1 <br />2. BUILDING PLANS <br />TOTAL <br />82 <br />00 <br />9. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION _ <br />WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS 16 YOUR PERMIT' _- <br />! ._.._ •7 O <br />11 qzT <br />6. GRADING <br />S DRAINAGE <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />00 <br />8, HEALTH DISTRICT <br />C) <br />APPLICATION ACC <br />CHECKED BY <br />APPR. FOR ISSUANCE DY <br />7BYPLANS <br />HWM <br />I <br />ADDRESS FILE <br />