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r <br />"9 <br />the L'Yrrgrrrn <br />J 0 N S T R U C T I 0 P' <br />everett <br />PERMIT <br />PERMIT NO. <br />IL2047 <br />CITY HALL 259.8745 <br />❑ <br />EVERETT, WA 98201 <br />❑ COMBINATION XX BUILDING MECHANICAL <br />PLUMBING <br />r <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />✓NONF <br />PEARL MILLER <br />2520 - 73rd ,. Everett WA 9R909 <br />351-1999 <br />AFIrMMRS. <br />l OR pESIGNER <br />MAIL ADDRESS CITY <br />21P <br />PHONE <br />Northern Sun <br />21705 High wav 99 Lynnwood WA 98036 <br />771-1aa4 <br />GENERAL CONTRACTOR <br />MAR ADDRESS CITY <br />71P <br />PH NE IICENSEF <br />Burke Phillips <br />Construction 16821 F2nd Ave NW Stanwnnd <br />6R9-Anln <br />RIIRKFPC20 F <br />MECHANICAL CONTRACTOR <br />MAIL AOORESB CITY <br />ZIP <br />PHONE LICENSE F <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE F <br />LIE! <br />L <br />... V - ❑ NEW L3 ADDITION ❑ ALTERATION ❑ REPAIR Cl DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />E 9,000.00 <br />DESCRIBE WORK <br />PROPOSED USE OF BUILDING V" , <br />Sin i e famil residence <br />I HEREBY CERTIFY THAT I HAVE READ 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 PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE DATE <br />x TUHRDG <br />LEGAL DESCRIPTION OF PeROPERTY (SHOW BELOW OR ATTACH FOUR CANES) <br />LOT $ BLOCK 46 OF Pinehurst IIEII <br />W 801 Of E 1041 of Lot 3 <br />JOB ADDRESS <br />2520 - 73rd <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO.1 <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />OAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.0 M <br />LAUNDRY TRAY <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 />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />f <br />SUBTOTAL t <br />_ <br />PERMIT <br />f <br />PERMIT P <br />TOTAL FEE <br />! <br />TOTAL FEE B <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES I:NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />ZEELIPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />%000P00 <br />74 <br />50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MA%. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DAtE <br />1. ENVIRONMENTAL CHEL A LIST <br />PENALTY <br />U.B.C. <br />SEC. 307 UI <br />2. BUILDING PLANS <br />TOTAL <br />]Q <br />5D <br />]. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />GOADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIB,SRACp THIS 6 o09F�E5NOT —r--;'S. <br />/6V7 i I v <br />0 <br />FOUR RECEIPT <br />THANK Y O U <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />STG <br />PLANS CHECKED BY <br />DAB <br />APPR. FOR ISSUANCE BY <br />I DAB <br />—1api8S <br />J <br />L. <br />ADDRESS FILE <br />.J <br />