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the Evergreen .- CONSTRUCTION cvc.rett <br />1 <br />CITY Or PERMIT <br />everett <br />CITY HALL 250874b <br />EVERr:TT, WA 98201 COMBINATION • BUILDING • MECHANICAL PLUMBING ,e <br />OWNER MAIL ADDRESS ZIP PHONI <br />Frederick R. Johnson 1507 Blst Place S.E. Everett 353-5098 m <br />ARCHITECT OR DESIGNER MAIL ADDRESS PIIONk 1 ICE NSE NO <br />GENE nAI. CONTRACTOR MAIL ADDRESS PHONE LICCNSE NO. 7 <br />lame C <br />MECHA •'ICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. E: <br />W <br />m <br />-.. PLUMOING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. m <br />PERMIT CLASS OF WORK 1 <br />❑ COMBINATION <br />I ❑BUILDING ❑PLUMSING (]MECHANICAL <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />$ 1, 000. 00 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />interior finish <br />PROPOSED USE <br />single family MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH TYPE OF ENERGY ❑OAS ❑ELEC. <br />FOULAI3PIES) 7 BeverlyPark <br />LOT L4 BLOCK —OF NO. TYPEEQUIPMENT FEE <br />AIR COND. UNITS-H.P. EA. $ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERG-R.P. EA. I <br />_ FORCED AIR SYSTEMS-B.T.U. MCA. <br />JOB ADDRESS SPACE S WALL HEATERS - P.T.U. _ <br />1507 Blst Place S.E. UNIT HEATERS-R.T.U. I <br />EVAPORATIVE COOLERS <br />PLUMBING cLOTHESORVERs I <br />VENTILATION FAN <br />_ RANGE HOOD I <br />NO. TYPE OF FIXTURE OR ITEM FEE AIR HAND ING UNIT C.F.M. <br />BATH TUBS S <br />CLOTHES WASHER <br />WATER HEATER_ <br />DISH WASHERS I FAC BUILT FIREPLACE & CHIMNEY I <br />DRINKING FOUNTAINSFLOOR DRAINS - - _GAS. SYSTEM NO GP OUTLETS <br />KITCHEN SINKS l• EmssunTOIAL i I <br />BAR SINKS PERMIT S <br />ROOF DRAINS - RAIN LEADERS TOTAL FEE S 1 <br />SHOWER BATHS THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC 1, <br />SERVICE SINKS 7ION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF 1 <br />SUMPS - SEWAGE PUMP CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />URINALS PERIOD OF 170 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />WATER CLOSETS 2 I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS A <br />PRIVATION AND KNOW THE SAME TO HE TRUE AND CORRECT. ALL <br />1 <br />WATER HEATERS -ELECTRIC I PROVISIONS OF LAWS ANDCOMPLIED <br />ORDINANCES GOVERNING THIS TYPE <br />WASH BASINS 1 Of WORK WILL BE TING OF PE WHETHER SPECIFIED HEREIN <br />LAUNDRY TRAYS GI NOT, THE GRANTING LA A PERMIT GOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE DR CANCEL THE PROVISIONS Of <br />ANY OTHER STATE C LOCAL LAW REGULATING CONSTRUCTION <br />I OR THE PERFORMANCE OF CONSTRUCTION. <br />SUB TOTAL <br />PERMIT _ S 1 TOTAL FEE $I <br />X OFCONTRA16 77 <br />WATER SERVICE SIZE BLDG. SUPPLY SIZE _ SIG A TURECTO OH. AGENT DATE <br />SIDE YARD SETBACK STREEISETOACK REARYARDSETBACK Pi AN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE LOT AREA VACANT SITE <br />OYES ONO FEES VALUATION FEE <br />TYPE OF CONST. OCCUPANCY GROUP NO. OF DWELLING <br />UNITS I <br />SIZE OF BLDG. NO. OF STORIES MAX. OCC. LOAD BUILDING 81 r 000. 00 1O1 OO <br />FIRE ZONE BASEMENT I I ME S RINK LERS PLUMBING 71 OO <br />REOUIRED <br />OYES ONO MECHANICAL I <br />SPECIAL CONDITIONS_ OTHER <br />T- <br />-Y. ---- — PENALTY SEC. 303(•) 1 <br />TOTAL 1 71 OO 1 <br />—/�''�. PERMIT VALIDATION ` tt •. 1 <br />_--\r%---------- --- WHEN PROPFRI Y VAL MATTO IIN INI�! 4"r, T I. I OU/i PERMIT <br />if <br />--------- -- THANK Y01 W <br />n Plln. i �: �1PI11r 1f 1p" <br />11S 1.r111.1111 NY nPPnuvHH urn:finnNlll Mr .�. <br />e .� I K.C.eb ► ! <br />B its ] <br />I ' 1 <br />w n(:1"13L"'r 1i11 1 <br />i <br />