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"ONSTRUCTION <br />everett <br />PERMIT PERMIT NO. <br />CITY HALL 2598745 <br />❑ <br />EVERETT, WA 98201 ❑ COMBINATION k-X� BUILDING MECHANICAL PLUMBING <br />OWNER <br />MAIL ADORES:, ZIP " <br />CHARLES BURDSAL 2232 - <br />74th Everett <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY 71P PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY 71P PHONE LICENSE F <br />Damage Repair Service <br />Box 2045 Everett WA 98203 337-4222 DAMAGI238D3 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS City ZIP PHONE LICENSE F <br />CLASS OF WORK <br />❑ NEW ❑ADDITION ❑ALTERATION (� REPAIR ❑ DEMOLITION ❑FENCE ❑SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />VALUATION OF WORK <br />115,000. <br />DESCRIBE WORK <br />Fire damage repair - sheetrock, cabinets, doors,windows, insulation, roofing, <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />z <br />O <br />Residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />rn <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT 9 BLOCK 3 OF VUena Vista <br />HGmpr. <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />.... <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />„-i <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />m <br />PERFORMANCE OF CONSTRUCTION. <br />JOB ADDRESS <br />SIGNATT E OF GONTPACTOR O AUT OEO AGENT GATE <br />o <br />M 0 <br />2232 - 74th <br />X Z' � 10/12/84 <br />c <br />033 <br />PLUMBING <br />MECHANICAL/ <br />-I Z <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />m ~ <br />,. <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS - H.P. EA. <br />q Z <br />C <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA. <br />--I <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />N <br />SHOWER <br />_ <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />.< T <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS - B.T U. M EA. <br />0 ;0 <br />In <br />DISHWASHER <br />WALL HEATERS -B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. Mrn <br />-_ <br />S <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />N <br />WATER HEATER <br />CLOTHES DRYFRS <br />m <br />URINAL <br />VENTILATION FAN <br />N <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />-_{ r <br />VACUUM BREAKERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR, ETC.1 <br />FIREPLACE INSERT <br />' <br />HEAT PUMP <br />z <br />S <br />r <br />1/t <br />SUB TOTAL <br />1 <br />TOTAL 1 <br />BE <br />CD <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />S <br />TOTAL <br />FEE f <br />rn <br />SIDE YARD SETBACK <br />PLAN CHECK FEE <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />FEE RECEIPT NO. <br />USE ZONE <br />VALUATION FEE <br />LOT' AREA <br />VACANT SITE <br />FEES <br />.YES NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f t nnn <br />NO. OF STORIES <br />MAX. OCC. LOAD4�.�� <br />SIZE OF BLDG. <br />PLUMBING <br />FIRE ZONE BASEMENT <br />RERE OUSRED PRINKLEH <br />MECHANICAL <br />YES NO <br />APPROVALS <br />OTHER <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIFT <br />PENALTY U B.C. <br />BEG JOG (&l <br />2. BUILDING PLANS _ <br />— TOTAL 11 5D <br />0. FIRE HV DRANT <br />4. FIRE PROTECTION SYSTEM <br />_ <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS �'O�II�• P901RIT — "4 <br />S.GRAOINO <br />B. DRAINAGE <br />C:) <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />I _ d- <br />B. HEALTH DISTRICT <br />II I r-I <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE uY • <br />L I <br />ADDRESS FILE <br />