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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />CONSTRUCTION <br />PERMIT <br />❑ COMBINATION i3d BUILDING Ll MECHANICAL <br />PERMIT NO. 06821 <br />0 PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />/IP <br />98203 <br />PHONE <br />353-2476 <br />Will Olson <br />2201 74th Street S.E. <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENER d CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSEE <br />Same <br />MAIL ADDRESS <br />CRY <br />ZIP <br />PHONE LICENSE F <br />MECHANICAL CONTRACTOR <br />PLUMBING CONTRACTOR <br />MAIL,DDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />CLASS OF WORK <br />CRNEW []ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN 013JURAGE <br />VALUATION OF WORK <br />f 1400.00 <br />DESCRIBE WORK <br />.r4 e4Nn a7 ATl <br />PROPOSED USE OF BUILDING <br />single family residence <br />AP - <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 />LEOALDESCRIPTIONOFPROIERTY(SHOWBELOWORATTACHFOURCOMES) <br />17-18 42 Pinehurat Div. <br />D <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT BLOCK —Of <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 />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF OONTRACTOR ON AUTHOR17ED AGENT DATE <br />X ® XsXYSX11x <br />JOB ADDRESS <br />2201 74th Street S.E. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS - H.P. EA <br />REFRIGERATION UNITS - H.P. EA <br />BATHTUB <br />LAVATORY ASH BASIN <br />BOILERS - H.P. EA. <br />GAS FIRED A.C. UNITS - TONNAGE EA <br />SHOWER <br />FORCED AIR SYSTEMS - B.T.U. M EA <br />KITCHEN SINK b DISP. <br />WALL HEATERS - B.T.U. M <br />DISHWASHER <br />UNIT HEATERS — B T.U. M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />WATER HEATER <br />CLOTHES DRYERS _ <br />VENTILATION FAN <br />URINAL <br />DP;rri!NG FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT - 6 F M <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE b CHIMNEY <br />SINK SERVICE - BAR, ETC <br />SUBTOTAL f <br />SUBTOTAL <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />TOTAL FEE f <br />SIDE YARD SETBACK STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />R-2 <br />_ <br />TYPE OFN NST, <br />OOCU ANQV GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$1400.00 <br />00 <br />11 <br />SIZE OF BLDG <br />NO. OF STORIES <br />MAK. DOC, LOAD <br />E:14 <br />16' x32' <br />1 <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />CITIES ED NLEt1S <br />MECHANICAL <br />3 <br />L7YE6 ONO <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1, ENVIRONMENTAL CHECK LIST _ <br />PENALTY <br />U B.C. <br />SEC. 303(A) <br />2. BUILDING PLANS <br />TOTAL _ <br />14FOO <br />3. FIRE HYDRANT <br />0. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />shoo So 14.10 as <br />t <br />« <br />_ <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />YOUR RECEIPT c <br />THAW YO U <br />S. HEALTH DISTRICT <br />APPLICATION AOC, BY <br />PLANS CHECKED BY <br />APPR, FOR ISSUANCE PY <br />V.C. <br />