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the Evergreen <br /> CITY OF "�O N ST R U CTI O N-- <br /> everett PERMIT PERMITL. 0 935 <br /> CITY HALL 2598745 <br /> EVERETT,WA 98201 ® COMBINATION ® BUILDING ® MECHANICAL JJ PLUMBING T» <br /> OWNER MAIL AUOm S., (1" ]II• , Pnl It1l a <br /> Brad Hanson 940 North 91st Seattle 98103 527-156n c, <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONL tJ <br /> OENEML NTR TOR MAIL ADDRESS City 710P., PHONe -ICENSE <br /> tlame <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP lf� PHONE LICENSE 1 <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE P <br /> CLASS OF WORK <br /> 1bEW <br /> EW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> s 45,000. 00 <br /> DESCRIBE WORK <br /> Construct Single Family residence <br /> PROPOSED USE OF BUILDING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGAL DESCRIPTroNOFPROPERTY(SHOW BELOW OR ATTACH FOUR COMES) — PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 1 Beverl Home Sites ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> LOT BLOCK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLAjfi OR CANCEL THE PRO. <br /> VISIONS OF ANY OTHER STATE OR LO AL LAW REGULATING <br /> CO S UCTIO R T RF ANCE F CONSTRUCTION. <br /> SIG 1 IRA TO O 11 ]IIIZLD ,E 1 DAIS <br /> MR ADDRESS 3/19/81 <br /> 118 76th Street S .W. X <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIFFMENT FEE _ <br /> 2 WATER CLOSET(TOILET) AIR COND.UNITS—H.P.EA. _ <br /> 1 BATHTUB _ REFRIGERATION UNITS—N_P.EA <br /> 2 LAVATORY ASH BASIN BOILERS—H.P.EA. _ <br /> 1 SHOWER I In In GAS FIRED AC UNITS—TONNAGE EA <br /> 1 KITCHEN SINK 8 DISP I n n1 FORCED AIR SYSTEMS—8U. M EA <br /> 1 DISHWASHER 9 WALL HEATERS—B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER I EVAPORATIVE COOLERS <br /> WATER HEATER 0 1 CLOTHES DRYERS <br /> URINAL 2 VENTILATION FAN <br /> DRINKING FOUNTAIN 1 RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C F M <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS I METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE—BAR.ETC) <br /> _ SUB TOTAL 2 SUB TOTA f 2 <br /> PERMIT f PERMIT f <br /> TOTAL FEE f TOTAL FEE f <br /> SIDE YARD SETBAC( STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 61 IF' 169. 33 RES1f7 S tlE <br /> USE ZONE LOT AREA VACANT SITE b <br /> R-I 10,500 SQ. )tWES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO,OF DWELLING UNITS <br /> V-N R-3 1 BUILDING 1145 ,000. 260 50 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAD <br /> I PLUMBING 20 00 <br /> FIRE ZONE BASEMENT FIRE REOUIRPRSqIN�KLERS MECHANICAL 25 <br /> None <br /> IYES t1N0 50 <br /> APPROVALS BY DATE OTHER <br /> T ENVIRONMENTAL CHECK LIST PENALTY UB C. <br /> 2, BUILDING PLANS SEC.3031a1 <br /> 3, FIRE HYDRANT ,n TOTAL 306 00 <br /> 4. FIRE PROTECTION SV M PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING <br /> N B. DRAINAGE O. <br /> 7. ENVIRONMENTAL IMPACT STATEMENT cr) <br /> f- <br /> :DI <br /> B. HEALTH DISTRICT OJ <br /> li I O <br /> PJO APPLICATION ACC.BY _ o PLANS CHECKED BY APPR,FOR ISSUANCE BY <br /> V.C. J <br /> C -„ <br /> ADDRESS FILE <br />