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r'ONSTRUCTION <br /> II , <br /> everett PERMIT PERMIT NO. 09960 <br /> CITY HALL 259.8745 <br /> EVERETT.WA 98201 n COMBINATION IX) BUILDING I I MECHANICAL PLUMBING <br /> OWNER !1- 'DDRESS IIP I.. '.. <br /> R. G. Johnson 116 79th Pl. S.E . Everett 98203 355-1566 <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br /> Same <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> PLUMBING CONTRAC'OR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br /> CLASS OF WORK <br /> ❑NEW ! 1ADDITION R73.LTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> f 41000.00 <br /> DESCRIBE WORK <br /> finish existi-ig basement <br /> PROPOSED USE OF BOILDINfI <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGAL DESCInr ,W BELOW OR ATTACH FOUR COMES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 20 Ever Ridge ALL PROVISIONS OF LAWS AND ORDINANCES GOVERN!:!G THIS <br /> LOT BLOC, OF Evergreen 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 VIOLATE OR CANCEL THE PRO. <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFO MANCE OF COUSTRUCTION. <br /> JOB ADDRESS SIGNAIU 0 'ONt ,t OR AVI On J TEN) DATE <br /> 11E 79th Place S.E. X 0/30/81 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE _ <br /> WATER CLOSET(TOILET) 2 00 AIR GOND UNITS— H P EA <br /> BATHTUB REFRIGERATION UNITS--H.P EA <br /> L LAVATORY(WASH BASIN) 2 BOILERS—H P EA <br /> SHOWER GAS FIRED A C.UNITS—TONNAGE EA <br /> KITCHEN SINK 6 DISP, FORCED AIR SYSTEMS—B T U M EA _ <br /> DISHWASHER WALL HEATERS--B T U IA <br /> LAUNDRY TRAY UNIT HEATERS—B.T.0 M <br /> CLOTHES WASHER I EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HAHOLING UNIT— CFM. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINL `ERS METAL FIREPLACE 8 CHIMNEY ' <br /> SINK(SERVICE—BAR.ETC) <br /> SUBTOTAL 4 SUBTOTAL f <br /> PERMIT f PERMIT f <br /> TOTALFEE $1 4 00 TOTAL FEE f <br /> SIDE YARD SETBAC< STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> [(YES [IND FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> SIZE OF BLDG NO.OF STORIES MAX DOC.LOAD BUILDING $41000.00 44 50 <br /> PLUMDING 4 <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REQUIRED MECHANICAL <br /> (]YES LINO <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U BC. <br /> . <br /> 2. BUILDING PLANS SEC303(A) <br /> 3. FIRE HYDRANT TOTAL 48 kn <br /> 4, FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED IIN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING <br /> 6 DRAINAGE (� <br /> 7. ENVIRONMENTAL IMPACT STATEMENT (T) <br /> B. HEALTH DISTRICT _ O <br /> APPLICATION ACC EY PLANS CHECKED BY APPR.FOR ISSUANCE BY <br /> l AnDRFS <br /> 5 Fil.r <br />