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i <br />the EVTO <br />f ONSTRUCTION <br />CITY OFF <br />CI <br />evereit <br />PERMIT <br />PERMIT NO.11021 <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 <br />❑ COMBINATION ��! BUILDING U MECHANICAL <br />U PLUMBING <br />OWNER <br />MAR AOUHL" I.HY <br />dP PNON! <br />JIM ANSTIS <br />420 - 92nd St Everett WA <br />98204 355-5465 <br />ARCHITECT NIA DESIGNER <br />MAIL ADDRESS CITY <br />ZIP PHONE <br />GENERAL CONTRACTION <br />MAIL ADDRESS CITY <br />ZIP PHONE IIU NSLI <br />Owner <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP P-NONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL AGGRESS CITY <br />ZIP PHONE LICENSE <br />❑NEW ADDITION ❑ALTERATION ❑REPAIR )MEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />S <br />DESCRIBE WORK <br />Demolish single family residence <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE 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 />SIGNATU OF CONTRACTOR OR AUTHORIZED AGENT HATE <br />X - ?;i A 9/17/82 <br />LEGAL DESCRIPTION OF PROPERTYIBHOW BELOW OR AnACH FOUR COPIESI <br />n <br />LOTI_yR FILOCK 22 1EA - <br />88 deg. 46137" E 289.301 to TPE TH <br />cont 1 11 F TH <br />S 650.681 TH W 332.901 TH N 657.791 t <br />TPH <br />MR ADDRESS <br />420 - 92nd St. (Apprx) <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 OILET) <br />AIR COND. UNITS — H.P. EA, <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK 6 DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />_ <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.0 M <br />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />I 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 6 CHIMNF <br />SINK SERVICE — BAR. ETC) <br />SUB TOTAL <br />SUB TOTAL { <br />PERMIT { <br />PERMIT { <br />TOTALFEE <br />TOTAL <br />FEE <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 />".YES LEND <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />{ <br />00 <br />00 <br />SIZE OF BLDO. <br />NO OF STORIES <br />MA%. 001: LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FUZE SPRINKLERS <br />REOUIRED <br />I)YES UNO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U BC <br />SEC. 303 (a) <br />2 BUILDING PLANS <br />TOTAL <br />00 <br />00 <br />3. FIRE HYDRANT <br />E FIRE PROTECIION SYSTEM <br />6 GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />e-i <br />7641 10 0 0. 0 0- C*4 <br />O <br />r-A <br />YOUR RECEIPT `-' <br />THANK, YOU <br />B. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PUNS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE 17 SE 82 <br />