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Me hergrrrn <br />( IT, (,I <br />everett <br />CITY HALL 2i98745 <br />EVERETT, WA 98201 <br />CONSTRUCTIO'' <br />PERMIT <br />❑ COMBINATION U BUILDING ❑ MECHANICAL <br />PERMIT NO. 15002 <br />CJ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />Cn , <br />ZIP <br />PHONE <br />MORRIS PAYNE <br />102 - 74th S. E. <br />Everett IVA 98203 <br />3S3-0964 <br />ARCHITECT OR DESIGNER <br />- MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE A <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE F <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZI' PHONE LICENSE F <br />❑ NEW ❑ ADDITION ❑ ALTERATION 10 REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALU.HON OF WORK <br />s 500.00 <br />Reroof <br />PROPOSED USE OF BUILDING <br />Single family residence <br />I HEREBY CERTIFY CHAT 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 PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />P NCE OF NS CTION. p�L E <br />IGNATU CONTRALTO R AUTN RI D AGENT 6�19/ O <br />�Sj <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOY-2.—BLOCK_OF Beverly Acrg Tracts <br />JOB ADDRESS <br />102 - 74th S. E. <br />PLUMBING <br />MECHANICAL —•� <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMEW <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION U.GTS — H,P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK DISP. <br />FORCED AIR SYSTEMS — G.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY FRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />— <br />FI.00R DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEAOERS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE — BAR, ETC) <br />FIREPLACE INSERT <br />MEAT PUMP <br />SUB TOTAL <br />3 <br />SUB TOTAL t <br />_ <br />PERMIT <br />{ <br />PERMIT t <br />_ <br />TOTALFEE <br />$1 <br />1 <br />TOTALFEE t <br />S1DE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHICK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />.YES ..NO <br />FEES <br />VALUATION <br />FEE <br />_ <br />TYPE OFF— <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />i 500 00 <br />lO <br />OO <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />9ASFMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />OTHER <br />^ <br />APPROVALS <br />by <br />DATE <br />_ <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SECC. (Al <br />I_ <br />2. BUILDING PLANS <br />- <br />TOTAL <br />10 i0o <br />O. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT (�I <br />CD <br />� <br />1 <br />B. DRAINAGE <br />I.ENVIRONMENTAL IMPACT STATEMENT <br />B, HEALTH DISTRICT <br />APPLICATION ACC. BY <br />stg <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ti —1 <br />N 2 <br />v <br />m <br />co <br />mo <br />-M C <br />o� <br />_ - <br />m <br />oz <br />yC <br />t"' S <br />H H <br />�'n <br />T <br />rn H <br />VI <br />v <br />9 m <br />C (A <br />LA <br />C <br />H <br />S <br />Un <br />Z <br />O <br />rn <br />m <br />ADDRESS FILE <br />