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the Evergreen '^O N ST R U CT I O V <br /> CITY OF <br /> everett PERMIT PERMIT NO. 10699 <br /> CITY HALL 259 NN•5 <br /> EVERETT,WA 98201 ❑ COMBINATION RK BUILDING U MECHANICAL ❑ PLUMBING <br /> OWNER MAIL AUUIILy CRY ZIP PHONE <br /> DAVID R. NURVIN 117 - 79th P1 SE Everett WA 98203 355-7220 <br /> ARCHITECT OR DLSIGNLR MAIL ADDRESS CITY ZIP PHONE <br /> Glen Hunt and Assoc. 559 NE 80th St Seattle 98155 522-2334 <br /> A NERAL CONTRACTOR MAIL ADDRESS CRY ZIP PHONE LICENSE I <br /> Owner <br /> !IF CHANIGAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE/ <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br /> CLASS OF WORM <br /> MEW []ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION DEFENCE [I SIGN ❑GARAGE <br /> VALUATION OF WORT( <br /> s 300.00 <br /> DESCRIBE WORK ' <br /> Retaining wall <br /> PROPOSED USE OF BUILDING <br /> Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 000 Evergreen Ride ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> Lor 4 BLOCK_x 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 T PERFORMANCE OF CONSTRUCTION, <br /> JOB ADDRESS SIGNATURE TRACTOR A 7N0111 AGENT 1 DATE <br /> 117 - 79th PI SE X 6/23/82 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNITS—H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA <br /> LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED AC.UNITS—TONNAGE EA <br /> KITCHEN SINK 6 DISP. FORCED AIR SYSTEMS—B.T.U. 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 HOOU <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 /> SUBTOTAL BUB TOTAL B <br /> PERMIT B PERMIT B <br /> TOTAL FEE 9 TOTAL FEE B <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA V Y 6 TI]NO FEES SITE VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> BUILDING s 300,00 10 00 <br /> SIZE OF BLDG NO.OF STORIES MAX.DCC,LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE REQUIRED PRINKLERS MECHANICAL <br /> LE1YES FIND <br /> _ APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303 Is) <br /> 2. BUILDING PLANS TOTAL - 10 0 <br /> 3. FIRE HYDRANT <br /> C FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> L. 5, GRADING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT rr��T3 <br /> B. DRAINAGE 4 19 1 <br /> 7. ENVIRONMENTAL IMPACT STATEMENT co <br /> O <br /> 8. HEALTH DISTRICT YOUR RECEIPT Y-+ <br /> APPLICATION ACC.BY PLANE CHECKED BY APPS.FOR ISSUANCE BY <br /> lc THANK YOU <br /> ADDRESS FILE 2 3 JW 82 <br />