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HE <br />G1 <br />the Evergreen `' O N ST R U CT I O N <br />CITY OF <br />everett PERMIT PERMIT NO.11297 <br />HALL 259-8745 <br />L VLHETT, WA 98201 [I COMBINATION LXJ BUILDING 4 MECHANICAL kJ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP NONE <br />Arthur Brandvold 1012 Park Drive Everett 98203 252-3952 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP INTONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP NONE LK:ENSE f <br />Same <br />JECHANICALCONTR::TOR MAIL ACT BESS CITY ZIP PHONE LICENSEE <br />PLUMBING CONTRACIOR MAIL ADDRESS GTY ZIP PHONE LICENSEE <br />CLASS OF WORK <br />KNEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />E 32,000.00 <br />DESCRIBE WORK <br />Construct Single Family Residence <br />PROPOSED USE OF BUILDING <br />Single Family Residence <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 />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OFF CONTRACTOR OR AUTHORIZED AGENT / DATE <br />LEGAL DESCRIPTION OF PROPERTY (SNOW BELOW OR ATTACII FOUR COPIESI <br />LOT 5 eLocK_oF Ward Addis <br />U 6 28 5 <br />JOB ADr,o <br />610 6 5 t h Place 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 OIL <br />AIR COND. UNITS --H.P. EA. <br />BATHTUB <br />2 <br />00REFRIGERATION <br />UNITS — H.P EA <br />LAVATORY ASH BASIN <br />BOILERS — H.P. EA, <br />SHOWER <br />GAS FIRED A C. UNITS — TONNAGE EA. <br />1 <br />KITCHEN SINK S DISP. <br />2 <br />00 <br />FORCED AIR SYSTEMS — B T U. M EA. <br />DISHWASHER <br />2I <br />WALL HEATERS — B T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B T U M <br />1 <br />CLOTHES WASHER <br />2 <br />00 <br />1EVAPORATIVE COOLERS <br />1 <br />WATER HEATER <br />2 <br />n a <br />I <br />CLOTHES BYERSD <br />URINAL <br />1 <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />1 <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 />SUB TOTAL <br />SUBTOTAL f <br />PERMIT <br />f <br />PERMIT <br />TOTAL FEE <br />f14 <br />TOTAL <br />FEE <br />12 <br />JUL <br />SIDE YARD SE76ACK <br />51 <br />STREET SETBACK <br />201 <br />REAR YARD SETBACK <br />201 <br />PLAN CHECK NUMBER <br />82/11297 <br />PLAN CHECK <br />FEE <br />122.53 <br />FEE <br />RECEIPT NO. <br />60821 <br />USEZONE <br />R-2 <br />LOT AREA <br />VACANT SITE <br />(.)ES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CLNST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />1 <br />BUILDING <br />$32,000. <br />202 <br />00 <br />tfiifEOFDF' rig E+ <br />FIRE ZONE <br />NO. OF STORIES <br />BASEMENT <br />MAX. OCC. LOAD <br />FIRE 6PRINKLERS <br />REOUIRjD <br />nYES7EC MO <br />PLUMBING <br />MECHANICAL <br />14 <br />12 <br />00 <br />50 <br />APPROVALS <br />BY <br />DATE <br />JOYNER <br />I. ENVIRONMENTAL CHECK LI3T <br />PENALTY <br />USC. <br />SEC. 303 (e) <br />2. BUILDING PUNS ee <br />TOTAL <br />2 2 8 <br />0 0 <br />8-FIRE HYDRANT NIf <br />—4. FIRE P-R�OTrE-C�HON SYSTEIr <br />INC- -) <br />P. ORADINC- V <br />O 9 <br />PERMIT VALIDATION <br />MIEN fgPLnIg VAUUATLSIN THIS SPACE) THIS IS YOtA PERMIT <br />d U 1 4 U U E� <br />O 9 L' $16 i. 0 O <br />R RECEIPT a— <br />I' �'� K YOU Yq" 1.(f <br />THANK You I <br />,SE DRAINAL* , d <br />ENVIRONMENTAL IMPACi.YEATEMENT <br />rw <br />B. HEALTH D ST T • <br />P 10PLICATI A(JC)BY <br />MB.;D <br />NS CHECKED BY <br />I HWM <br />APPR. FOR ISSUANCE BVT <br />LC <br />y <br />i UCU 0 L <br />ADDRESS FIT_[ <br />