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r- <br />r <br />L <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />CONSTRUCTIOt <br />PERMIT <br />PERMIT NO. 09448 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUMBING <br />OWNER MAIL ADOAESS CIIY PHONE <br />DANIEL SCOTT 912 gird A_ W_ PVPRwTT 98207 <br />AACHRECT ON DESIGNER MAIL ADDRESS CITY ill 355 <br />GENERAL. CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br />MECHANICAL CONTRACTOR MAIL ADDRESS City ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />ENERGY PRODUCTIONS SYSTRMr 71705 Hwy 09 TYUNWOOM Donee 77A-g030 <br />CLASS OF WORK <br />❑NEW ADDITION ❑ALTERATION IIREPAIR ❑DEMOLITION [-]FENCE CI SIGN ❑GARAGE <br />INSTALL WATER HEATER <br />PROPOSED USE Of BUILDING <br />SINGLE FAMILY RESIDENCE <br />1 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 />SIGNATURE OF CONTRACTOR OR AUTHOl AGENT DATE <br />X BY CHECK 2661 7/1/a2_ <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR All FOUR CORE& <br />LOT FROCK -OF <br />JOB ADDRESS <br />912 93rd S. E. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET BOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — M.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A . UNITS —TONNAGE EA. <br />KITCHEN SINK f DISP. <br />FORCED AIR SYSTEMS — B.T.0 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 />I 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 — C.F M. <br />VACUUM BREAKERS <br />ISTOVE <br />ROOF DRAINS — RAINLEADERS <br />I METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE — BAR. ETC) <br />BUN TOTAL <br />SUBTOTAL f <br />PERMIT <br />f <br />3 <br />0 <br />PERMIT f <br />TOTAL FEE <br />TOTAL <br />FEE f <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 SITE <br />I IYES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO OF STURIES <br />MAX DOG. LOAD <br />PLUMBING <br />IRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRFD <br />[)YES LINO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALT ( <br />U B C <br />SEC. 303(B) <br />2. BUILDING PLANS <br />TOTAL <br />5 <br />00 <br />3. FIRE HYDRANT <br />A FIRE PROTECTION SYSTEM <br />5 GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED BN TIIIS SPACE) THIS IS YOUR PERMI I <br />M 1 o 7 i 0 0 S. U U <br />CD <br />YOUR R E C E I PTD <br />THANK YOU <br />B. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION Al BY I <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />- 7 JUL 8 2 <br />