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The Evergreen <br />CITY OF <br />everett <br />CITY HALL 2596745 <br />EVERETT, WA 98201 <br />CCNSTRUCTION <br />PERMIT <br />❑ COMBINATION chi BUILDING ❑ MECHANICAL <br />PERMIT NO. 08 748 <br />❑ PLUMBING <br />OWNER <br />MAIL AOORESS <br />CHY ZIP <br />PHONE <br />Robert C. Gaines <br />8623 loth <br />98204 <br />353-2038 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE A <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRES,. <br />CITY <br />ZIP <br />PHONE <br />LICENSEF <br />PLUMBING CONTRACTOR MAIL ADDRESi CRY ZIP PHONE LICENSE <br />CLASS Of WORK <br />0t1EW ❑ADDITION ❑ALTi RATION I29PAIR ❑DEMOLITION ❑FENCE ❑SKiN ❑GARAGE <br />VALUATION OF WORK <br />L 2400.00 <br />PROPOSED USE Of BUILDING <br />duplex <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 />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIESI <br />11 44 Pinehuret Div. D <br />DLocK_Df <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT <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 />CTION OR THE PERFORMANCE OF CONSTRUCTION. <br />B ADDRESS <br />1026 6 2028 74th Street <br />TAT!NTR <br />E CONTRACTOR OR AUT II D AGENT DATE <br />\ /,� 11/7/80 <br />X _ _ c2� <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET ILET <br />AIR CORD UNITS — H.P. EA <br />BATHTUB <br />REFRIGERATION UNITS — N.P. EA <br />LAVATORY ASH BASIN <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED AC. UNITE —TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B T U M <br />_ <br />LAUNDRY TRAY <br />UNIT HEATERS —B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />UhI NAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />1ANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC) <br />SUBTOTAL <br />SUBTOTAL <br />PERMIT <br />! <br />PERMIT f <br />TOTAL FEE f <br />TOTAL FEE f <br />SIDE YAP:• SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO . <br />US E ZONE <br />LOT AREA <br />SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST, <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f 2400. <br />38 <br />50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE RCO KLERSREO <br />MECHANICAL <br />CIYES ❑NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />_ <br />1. ENVIHONMENTAL CHECK LIST <br />PENALTY <br />Us C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />38 <br />50 <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />THIS IS YOUR PERMIT O —Ool <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) 1•1 S. <br />5. GRADING <br />8 DRAINAGE <br />7 ENVIRONMENTAL IMPAFSTATEMENT <br />CD <br />I i I <br />8 HEALTH DISTRICT <br />CD <br />APPLICATION ACC. BY <br />ED BY <br />APPR FOR ISSUANCE BY <br />18J <br />