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The ,11`..L!7C-'T <br />'ONSTRUCTION' <br />everett <br />PERMIT PERMIT NO. 14315 <br />CITY HALL 259 B745 <br />EVERETT, WA98201 [] COMBINATION <br />BUILDING MECHANICAL XXi PLUMBING <br />OWNER MAIL ADDFIESb CITY ZIP PHONE <br />Charles Burdsal 2232 74th Street Everett 98204 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />775-7377 <br />South County Plumbing 18632 79th Place West Edmonds 98020 <br />CUSS OF WORK <br />❑ NFW ❑ ADDITION 0 ALTERATION 0 REPAIR ❑ DEMOLITION ❑ FENCE 0 SIGN 0 WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />S <br />DESCRIBE wom'. <br />CD <br />PROPOSED USE OF BUILDING <br />-- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />o <br />n <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />m <br />LEGAL DESCRIPTION OF PROPERTY ISH(M BELOW OR ATTACH FOUR COPIESI <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT -BLOCK -OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />-4 -T <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />" -a <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />Iw m <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />c <br />PERFORMANCE OF CONSTRUCTION. <br />v <br />m o <br />JOB A <br />HSI! 74th <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />1/7/85 <br />C <br />Street <br />X <br />0 <br />A <br />-I <br />PLUMBING <br />MECHANICAL _ <br />m --I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />_ TYPE OF EQUIPMENT <br />FEE <br />O = <br />j <br />WATER CLOSET (TOILET) <br />2 <br />00 <br />AIR COND. UNITS - M.P. EA. <br />C <br />-� <br />_ <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />_ <br />LAVATORY (WASH BASINI <br />POILERS - IN . EA. <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />OO T <br />j <br />KITCHEN SINK A DISP. <br />2 <br />FORCED AIR GYSTEMS - B.T.U. M EA. <br />T <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRY TPAY <br />UNIT HEATERS - B.T U. M <br />w <br />N <br />j <br />CLOTHES WASHER <br />2 <br />00_ <br />EVAPORATIVE COOLERS <br />r <br />WATER HEATER <br />2 <br />CLOTHES DRYEnS <br />N <br />URINAL <br />VENTILATION FAN <br />- <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />1 <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />' <br />VACUUM BREAKERS <br />STOVE -WOOD <br />ROOF DRAINS - RAINLI'.-DERS <br />METAL FIREPLACE A CHIMNLY <br />SINK (SERVICE - BAR, ETC) <br />FIREPLACE INSERT <br />y_y <br />Y <br />HEAT PUMP <br />--I <br />a. <br />CD <br />O <br />SUB TOTAL <br />f <br />12 <br />00 <br />SUBTOTAL f <br />~ <br />PERMIT <br />f <br />3 <br />00 <br />PERMIT 1 <br />m <br />TOTAL FEE <br />3 <br />_ <br />TOTAL <br />FEE <br />f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />FEE <br />LOT AREA <br />VACANT SITE <br />--- FEES <br />VALUATION <br />YES NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDO. <br />15 00 <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />- — <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />P I KLERS <br />FIRE SPRINKLERS <br />MECHANICAL <br />!'YES NO <br />APPROVALS <br />OTHER <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY U.B.C. <br />SEC. 9091B) <br />2. BUILDING PLANS <br />TOTAL 15 00 <br />J, FIRE HYDRANT <br />�. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPAOE) THIS)SYlLrR PERMIT-_ <br />A. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />- I 1 <br />ADDRESS FILE. <br />