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r <br />L <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8145 <br />EVERETT, WA 98201 <br />rONSTRUCTION <br />PERMIT PERMIT NO.08558 <br />❑ COMBINATION BUILDING I 1 MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CIT, ZIP PHOH'. <br />Robert W. Brokaw 501 Colby Everett 98201 258-1109 <br />ARCHITECT OR DESK. :'•I MAIL ADDRESS CITY ZIP PFIONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP NICHE LICENSE I <br />Summit Western Inc. 501 Colby Everett 98201 258-1109 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE r <br />223-01-41446 <br />PLUMBING CONTRACTOR MAIL ADDHESS CITY ZIP PHONE LICENSE F <br />CLASS OF WORK <br />OiEW ❑ADDITION ❑ALTEM710N ❑REPAIR ❑DEMOLITION ❑FENC,E ❑SIGN '❑GARAGE <br />VALUATION OF WORK <br />f 4,000.00 <br />R......A -A.J- -It a-- n....T .. <br />PROPOSED USE OF BUILDING <br />Duplex <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. 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 />CONSTRUCTIO OR T PERFO ANCE OF CONSTRUCTION. <br />SIGN RE TOR R ENDFIZED NT DATE <br />X 12 / 1 / 8 0 <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR DOPIEST <br />LOT 1 _BLOCK1 OF <br />Lees the East 60' of the South ls2' <br />-- <br />JOB ADOPISS <br />1519 A S II 63rd Street S.E. <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 04 <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY IWASH BASIN <br />BOILERS — H.P. FA. <br />SHOWER <br />GAS FIRED A.0 UNITS — TONNAGE EA. <br />_ <br />KITCHEN SINK 6 DISP. <br />FORCED AIR SYSTEMS — B T U M EA. <br />- - <br />DISHWASHER <br />WALL HEATERS — B T U M <br />LAUNDRY TRAY <br />UNIT HEATERS — B T U M <br />CLOTHES WASHER <br />I EVAPORATIVE COOLERS <br />WATER HEATER <br />I 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 & CHIMNEY <br />_ <br />SINK (SERVICE — BAR. ETC <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />6 <br />TOTAL <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />LIVES ONO <br />FEES <br />VALUATION <br />I FEE <br />_ <br />TYPE OF CLNST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />s 4000. <br />44 <br />50 <br />SIZE OF BLDG <br />N0, OF STORIES <br />MAK. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERSREO <br />EYES LINO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 307(8) <br />2. BUILDING PLANS <br />TOTAL <br />44 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />1054 $044.50 �-03 <br />LO <br />Ca <br />n r <br />I I rC (_ I DT CD <br />^,NK YCU <br />S. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />_ <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />L.C. <br />ADDRESS FILE <br />-IDEC 80 <br />