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r <br />L <br />the Evergreen ^O N ST R U CT I O N <br />CITY OF <br />everetf PERMIT PERMIT NO.11472 <br />CITY HALL 2598745 <br />EVERETT. WA 98201 ❑ COMBINATION l BUILDING hL MECHANICAL ] PLUMBING <br />OWNf 9 14NI ADOFILSS I Ty IP PHONE <br />David Williamson 410 88th Everett 98204 355-5258 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS GPI ZIP PHONE LICENSE P <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHO14E LICENSE P <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE P <br />CLASS OF WORN <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR []DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />f _ <br />DESCRIBE WORK <br />Install wend Rtnvn <br />PROPOSED USE OF BUILDING <br />single family residence <br />IHEREBY CERTIFY THAT IHAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />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 PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />A I <br />X �c/i[.lJc^^ 1/28/83 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOr RLOCK_OF <br />- <br />JOB AODRL 5', <br />410 Beth Street <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR COND, .INITS - H P. EA <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA <br />LAVATORY ASH BASIN <br />BORERS - H P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- CFM <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR. ETC <br />SUB TOTAL <br />SUB TOTAL i <br />7—t <br />50 <br />PERMIT <br />f <br />PERMIT S <br />TOTAL FEE <br />S. <br />TOTAL <br />FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT S1TE <br />EYES L'NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CLNST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG, <br />NO OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRED <br />((YES LINO <br />MECHANICAL <br />17 <br />$0 <br />OTHER <br />APPROVALS <br />BY <br />DATE _ <br />_ <br />- - - <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C <br />SEC. 303111) <br />— <br />2. BUILDING PLANS <br />TOTAL <br />17 <br />ISO <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (114 THIS gSPACE) THIS I6 YOUR PF RMIT <br />L 8 G 3 S 011. 5.0 <br />V <br />T rl" U R R E C E I PT; -A <br />1 P I A N Ir Y O U <br />1 <br />S. GRADING <br />B. DRAINApE <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />l <br />ADDRESS FILE <br />