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the Evergreen Cr N S f R U CT I O N <br /> CITY OF <br /> everett PERMIT PERMIT NO. 07943 <br /> CITY HA.L 2598745 <br /> EVERETT.WA 98201 a COMBINATION Q BUILDING � MECHANICAL IXl PLUMBING _�\ <br /> OWNER <br /> CITYPHONE <br /> ggl04 355-0423 _ <br /> Thomas B Haugen Const 8614 53rd Place West <br /> an _ ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADDRESS <br /> CITY ZIP rHONE LICENSE <br /> GENERAL CONTRACTOR MAIL ADDRESS TH OM AH C243IR <br /> Same Zlp PHONE LICENSE/ <br /> MECHANICAL CONTRACTOR <br /> MAIL Ap0RE66 CRY <br /> ZIP <br /> PLUMBING CONTRACTOR MAIL ADDRESS <br /> CITY PHONE LICENSE 1 <br /> -U.S OF WORK <br /> [k%W ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑BION OGARAGE <br /> VALUATION OF WORK <br /> : 66 ,000.00 <br /> nTSL:R�eE vrDRii <br /> Construct Bingle family residence <br /> AP- <br /> PROPOSED USE OF BUILDIMS <br /> sinal@ f grail residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGAL DESCRIPTION OF FVIERT1 ISNOW BELO\VOR ATTACH FOUR COMESI PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> Evergreen Ridge ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> LOT 3 LOCK,—.-OF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING or A PERMIT DOES NOT <br /> _ PRESUME TO GIVE.AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> _ SIGNATURE OF NTRACTOR OR AUTHOR ED AGENT DATE <br /> ` �O,LOB ADDRESS y 11 aL� <br /> 119 79th Place S . E . I. <br /> �-- CHANICA <br /> PLUMBINGFEE <br /> NO, TYPE OF FIXTURE OR ITEM FE 4 00 NO EA <br /> TYPE OF EQUIPMENT _ <br /> 2 WATER CLOSET OILET) AIR UNITS—H P. . <br /> REFRIGERRIGER ATION UNITS—H.P.EA <br /> BATHTUB BOILERS—H.P.EA. <br /> 2 LAVATORY ASH BASIN GAS FIRED A.C.UNITS—TONNAGE EA. <br /> SHOWER 2 00 FORCED AIR SYSTEMS—8 U. M EA. 5 00 <br /> 1 KITCHEN SINK b DISP. U O WALL HEATERS—B.7 U- M <br /> DISHWASHER UNIT HEATERS—B T.U. M <br /> LAUNDRY TRAY EVAPORATIVE COOLERS <br /> CLOTHES WASHER1 CLOTHES DRYERS 3 00 <br /> WATER HEATER 1 2 00 <br /> VENTILATION FAN <br /> URINAL RANGE HOOD <br /> DRINKING FOUNTAIN AIR HANDLING UNIT— C F M <br /> FLOOR DRAIN STOVE <br /> VACUUM BREAKERS METAL FIREPLACE b CHIMNEY 0 <br /> ROOF DRAINS—RAINLEADER6 <br /> SINK(SERVICE—OAR.ETC. <br /> 18 00 SUBTOTAL f O <br /> 8U8 TOTAL PERMIT S <br /> PERMIT B TOTAL FEE S 6 <br /> TOTAL FEE S 18 0 0 <br /> SIDE YPUN CHECK FEE <br /> ARD SETLA <br /> SACK STREET SETBACK REAR YARD SETBACK PN CHECK NUMBER RECEIPT NO <br /> 794 3 FEE 109.! O <br /> 1 1 65 <br /> USE ZONE LOT AREA VACANT SITE FEEB VALUATION FEE <br /> LS ❑NO <br /> R-1 <br /> TYPE OF CONST, OCCUPANCY GROUP 3 N0.OF DWEL1NG UNITE $66 ,00:. . 219IGOV-N BUILDING <br /> SIZE OF BLDG NO.OF STORIES MAX.OCC.LOAD 18 00 <br /> PLUMBING <br /> 24 1 %261 <br /> FIRE ZONEBASEMENT FIRE SPR�DIINKLERS MECHANICAL 16 00 <br /> 3 <br /> Yea REE5Pq7(] FIO <br /> APPROVALS BY DATE OTHER <br /> LIBC <br /> 1. ENVIRONMENI'A ECK LIST PENALTY SEC 303(a) <br /> 2. BUILDING PLANS' TOTAL 253100 <br /> 3. F .IRE DRANO fiS�qp <br /> PERMIT VALIDATION -O J 6 1 "T"M <br /> �," 1O I.W 0 __ <br /> 4 FIRE PROTECTION SYSTEM WHEN PROPERLY VALIDATED(IN THi E THIS I .II RUT <br /> n 5 GRADING .� 6 3 6 0 18. 0 0 3 v <br /> 6. n IN E CT) <br /> 1. ENVIA MENTA' PACT STATEMENT _ Yi 1 H RECEIPT I•- <br /> B HEALo1sTRIc>' R=COPT ;�-�t;�J� YOU O <br /> API�AT®N ACC.B PLANS CHECKED BY APPR.FOR ISSUANCE BY. •,I �.,�,, <br /> -i V.C. <br /> 15auc80 15I-A 80 <br /> FILE <br />