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L_ <br />A''`ilT"�O° CONSTRUCTIO" <br />everett PERMIT PERMIT NO. 12287 <br />CITY HALL 2598745 <br />EVERETT. VIVA 98201 COMBINATION XX BUILDING MECHANICAL L PLUMBING <br />JWNEN MAILADWIE! UII ,P PHONE <br />Tom Menzel 2201 63rd Street Everett 98203 355-3342 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS �- <br />Rich Menzel 1405 Walnut Street <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />CITY — ZIP PHONE LICENSE I <br />,:verett 98201 252-7696 <br />CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY SIP PHONE LICENSE I <br />CI AM OF MORN <br />❑ NEW ❑ADDITION ❑ALTERATION Xy REPAIR ❑DEMOLITION ❑FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />L 1450.00 <br />re-ro <br />PROPO°ED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Single Family Residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />16 3 Finehurst Div. <br />A <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT —BLOCK —OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE <br />5449 003 016 <br />00 <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONST9UCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGIIATU OF COj'TRA TOR OR AUTHOPIZED AOENf DATE <br />-4--CA 8/2/83 <br />JOB ADDRESS <br />2201 63rd Street <br />X <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA, <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />_ <br />LAVATORY (WASH BASIN) <br />BOILERS — N.p. EA. <br />GAB FIRED A.C. UNITS — TONNAGE EA. <br />SHOWER <br />FORCED AIR SYSTEMS — B.T.U. M EA, <br />KITCHEN SINK S DISP. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />_ <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 — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE B CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUBTOTAL <br />{ <br />SUB TOTAL S <br />PERMIT <br />S <br />PERMIT <br />TOTAL FEE <br />S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />RECEIPT NO. <br />FEE <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />):YES :.NO <br />TYPE OF CONS . <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$1450. <br />25 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE BASEMENT <br />REQUIRED KLERB <br />MECHANICAL <br />.'.YES [:NO <br />APPROVALS <br />BY DATEUs <br />OTHER <br />I. ENVIRONMENTAL CHECK LIST _ <br />PENALTY <br />C <br />SEC. 307141 <br />SEC. <br />2. BUILDING PUNS <br />TOTAL <br />2 S <br />0 O <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />If Vn¢15E" <br />WHEN PROPERLY VALIDATED UN THISASA77 U <br />5.GRADINO <br />77 77 77tESTHIS <br />03 <br />CV <br />^ TT-- <br />YOUR RECCIPt <br />S. DRAINAGE <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />THANK Y O U <br />APPLICATION ACC. BY <br />PLAITS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />- 2 ALF; t, 3 <br />