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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT. WA BB201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />rnYNFR '.11 ADDRESS 71P PHONL <br />Kenneth M. Gast 12909 Seattle Hill Road Sno. 98290 337-6294 <br />'',rnITECT OR DESIGNER MAIL ADDRESS PHor, LIC NSE N(1. <br />m <br />z <br />W <br />m <br />^.ERAL CONTRACTOR LICENSE N(1. <br />Garryy Lareen___ 337-6294 <br />" CHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />OMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />I'I )MIT <br />❑COMBIH ATION <br />[IIJWILOING ❑PLUMBING ❑MECHANICAL <br />CLASS OP WORK <br />❑NEW ❑ADmTI(]N ❑ALTERAT ION fik3EPAIR <br />VALUATION OF WORK <br />$ O OO <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />repairing interior of residence <br />PROPOSED USE <br />single family residence <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACI4 <br />FOUR COPIES) <br />LOT BLOCK —OF Beverly Acre Tracts <br />West 60' of the East 340 feet Of Tract 10 <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />NQ <br />_ <br />TYPE OF EOUIPMENT <br />FEE <br />AIR CONG. UNITS-H.P. EA. <br />S I <br />11EF RIGERATION UNITS N.P. EA. <br />BOILERS R.P. EA. <br />I <br />_ <br />FORCED AIR SYSTEMS-A.T.U. MEA. <br />�- <br />JOB ADDRESS <br />211 74th Street S.W. <br />_ <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT 14EATERS R.T.U. <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES Onveps_ <br />1 <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />_ <br />AIR HANDLING UNIT C.F.M. <br />BATH TUBS <br />-- <br />- --- <br />WATER IOATFR <br />I AC BLI It T FIREPLACE & CHIMNEY I <br />r,ns_ Sv steM_NO OP o_U TLETs <br />SUB TOTAL $ I <br />PERMIT S <br />TOTAL FEE $ I <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUC71ON OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED, <br />I HEREBY CERTIFY 711AT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITI4 WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUT140SITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />X •?@L?&* <br />CLOTHES WASHER <br />DISH WASHERS <br />I <br />DRINKING FOUNTAINS <br />FLOOR DRAINS <br />KITCHEN SINKS IN DISP <br />BAR SINKS <br />ROOF DRAINS - RAIN LEADERS <br />SHOWER BATHS <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS -ELECTRIC <br />WASH BASINS <br />1 <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />PERMIT <br />S <br />_TOTAL FEE__ <br />WATER <br />SERVICE SIZESLOG. SUPPLY <br />SIZE <br />_ <br />SIGNAIUREOF CONTRACIORORAUTH.AGENT OnTE <br />SIOEYAROSETBJCK <br />.'ONE <br />STREETSETRACK REAR <br />YARDSETBACK <br />PLAN CHECK NUMBE R <br />PLAN CHECK FEE <br />FFE RECEIPT NO. <br />LOT AREA VACANT <br />SITE <br />OYES ONO <br />FEES <br />FEE <br />OF CONST. <br />OCCUPANCY GROUP WO <br />UNITS <br />—OF DW LL—LING <br />BUILDING <br />_VALUATION <br />1 <br />60 I oo <br />I <br />1 <br />� <br />OF BLDG. <br />NO. OF STORIES MAX. <br />OCC. LOAD <br />Pt UMAING <br />IONE <br />FIRLSPRINKLtHS <br />REOUIRED <br />OYES ONO <br />MECHANICAL <br />OTHER <br />'-I C(INDIII( NS <br />PENALTY <br />TOTAL <br />SEC ..103(a1 <br />I <br />60 100 <br />-- — -- <br />-------------_----- _-- <br />- ------------------ <br />PERMIT VALIDATION <br />WIIFNPROPFR1YVAt IDATEDIIN7111SSPACL)111131SY(IURP RMII <br />YOUR RECEIPT <br />THANK YOU <br />71U78 <br />