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the Evergreen CITY Of ^O N ST R U CT I O N <br />everett PERMIT PERMIT NO. 10905 <br />CITY HALL 259 8745 <br />EVEREft, WA 98201 ❑ COMBINATION ❑ BUILDING b MECHANICAL I I PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />EARL CALKINS <br />2005 - 74th St. <br />Everett 98203 <br />347-3825 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />DP <br />I qI <br />GFNERAL CONTRACTOR <br />MAIL ADDRESS <br />CRY <br />TIP <br />PHONE LICENSE I <br />OWNER <br />MECHANICAL OONTR UIOR <br />MAIL ADDRESS <br />CRY <br />TIP <br />PHONE LICENSE F <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />TIP <br />PHONE LICENSE F <br />CLASS OF WORK <br />)(ANEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />f <br />DESCRIBE WORK <br />Install wood stove <br />PROPOSED USE OF BUILDING <br />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 />PHESUME 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 OF CONTRACT APTHOHIZED AGENT DATE <br />X✓t( ��^ 8/20/82 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT BLacK__oF <br />JOB ADDRESS <br />2005 - 74th St <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(TOILET)_ <br />AIR COND UNITS — H.P. EA <br />REFRIGERATION UNITS — H.P. EA <br />BOILERS — H P EA <br />BATHTUB <br />_ <br />LAVATORY ASH BASIN <br />_ _ _ <br />SHOWER <br />GAS FIRED A UNITS —TONNAGE EA. <br />KITCHEN SINK 6 DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B T U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B T.0 M <br />CLOTHES WASHER <br />I 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 />VACUJM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK SERVICE — BAR. ETC.1 <br />Wood <br />BUD TOTAL <br />SUB TOTAL f <br />PERMIT { <br />PERMIT f <br />it— <br />00— <br />TO FAL FEE f <br />TOTAL <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT S1TE <br />❑YES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF B.DG. <br />NO OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />REOUIRED <br />OYES <br />SPRINKLERS <br />LINO <br />MECHANICAL <br />1 J <br />5O <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC. 303(4) <br />2, BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />17 <br />50 <br />4, FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED QN THIS SPACEI THIS IS YOUR PERMIT <br />6 5 3 8 E 017. 5 0 --� <br />Cn <br />O <br />YOUR RECEIPT <br />THANK YOU <br />8. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY __[PLANS <br />CHECKED BY <br />APPR. FOR ISSUANCE BY <br />J <br />ADDRESS FILE <br />20m;E2 <br />