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the Evergreen CONSTRUCTIONCITY OF <br /> everett PERMIT PERMIT NO. 09372 <br /> CITY HALL 2598745 <br /> EVERETT,WA 98201 ❑ COMBINATION RR BUILDING I ) MECHANICAL I PLUMBING <br /> MNLAUURESS CITY <br /> Leslie McGriff 4 76th Street S .W . Everett 98203 355-7714 <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP Ir14ONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PRONE LICENSE/ <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PRONE LICENSE# <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# <br /> G ASS OF WORK <br /> ❑NEW ❑ADDITION MHALTERATPJN ❑REPAIR ❑DEMOLItL]N ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION Of WORM <br /> $ 31000.00 <br /> DESCRIBF WORK <br /> Repair Its foundation--Block <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGAL OEMRIPT1049 PI OPERTY(SHOW BELOW OR ATTACH FOUR COPIES) PLICATION AND KNOW THE SAME 10 BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> LOT—BLOCK—Of —--._-_-- TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> 3935-000-001-0102 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 /> CONSTR CTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNAT F NT OII THORIZE NT DATE <br /> d5 ADDRESS 9 6/16/81 <br /> 4 76th Street S.W. X <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET OIL AIR COND UNITS-H EA. <br /> BATHTUB REFRIGERATION UNITS-H.P.EA <br /> LAVATORY ASH BASIN BOILERS-H .EA. <br /> SHOWER GAS FINED A .UNITS-TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS-BTU M EA. <br /> DISHWASHER WALL HEATERS-B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS-B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- C F M <br /> _ VACUUM BREAKERS STOVE <br /> ROOF DRAINS-RAINLEADERS METAL FIREPLACE 6 CHIMNEY <br /> SINK(SERVICE-BAR.ETC.) <br /> BUB TOTAL SUB TOTAL { <br /> PERMIT t PERMIT >< <br /> TOTAL FEE t TOTAL FEE <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT 40. <br /> USE ZONE LCT AREA OYESM ONNO FES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP OF DWELLING UNITS <br /> BUILDING $3,000. 38 50 <br /> SIZE OF BLDG NO.OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERSREOMECHANICAL <br /> OYES ONO <br /> _ APPROVALS BY DATE OTHER <br /> I. ENVIRONMENTAL CHECK LIST PENALTY UBC. <br /> _ - SEC 303(a) <br /> 2. BUILDING PLANS <br /> - TOTAL 38 0 <br /> 3. FIRE HYDRANT <br /> 4. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDAILD IIN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING R I� 2 0• C .-_ N <br /> 8. DRAINAGE h J U l r1 <br /> M <br /> 7. ENVIRONMENTAL IMPACT STATEMENT In <br /> B. HEALTH DISTRICT ELEE O <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY <br /> I I <br /> ADDRESS FiLE <br />