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the Evergreen <br /> CITY OF CO TRUCTION <br /> everett ERMIT PERMIT NO.• 06755 <br /> CITY HALL 259.8745 <br /> EVERETT,WA 98201 ❑ COMBINATION Li BUILDING ❑ MECHANICAL ® PLUMBING <br /> OWNER MAIL ADDRESS CITY ZIP PHONE • <br /> Richard Welch 8113 Xavier Way 98203 355-1803 <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> k Everett Builders Inc. 5606 Evergreen Way 98203 353-7161 <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br /> EV ER. EB 301PH <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 9 <br /> CLASS OF WORK <br /> ❑NEW LD ADDITION ❑ALTERATION El REPAIR ❑DEMOLITION L]!'GNCE [SIGN EGARAGE <br /> VALUATION OF WORK <br /> S RUM= 19,340.00 • <br /> DESCRIBE WORK <br /> Swirmning Pool Room <br /> PROPOSED USE OF BUILDING <br /> single family residence 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LLGALDESCRIPTICNOFPROPERTY ISHOWBELOW ORATTACNFOUR COPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> LOT 18 BLOCK OF Beverly Viewlands Div. 1 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 PVRANCE OF CONSTRUCTION. <br /> JOB R iS SIGNAPdR CONTRACTONT0 YORIZED AA E�NTT� / DATE <br /> 8` Q Xavier Way X .bff/ ,- . ( -rr/- >77e1f1�C_ / // 7l- <br /> ir <br /> PLUMBING MECH NICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> - <br /> WATER CLOSET ITOILETI AIR COND.UNITS-H P EA - <br /> BATHTUB REFRIGERATION UNITS-H P.EA <br /> LAVATORY(WASH BASIN) BOILERS-H P.EA. <br /> SHOWER GAS FIRED AC.UNITS-TONNAGE EA <br /> KITCHEN SINK F.DISP FORCED AIR SYSTEMS-ELT U. M EA. <br /> DISHWASHER _ WALL HEATERS-B T U 9,1 <br /> LAUNDRY TRAY UNIT HEATERS-B.T.0 1.1 <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL _ VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD -- <br /> FLOOR DRAIN AIR HANDLING UNIT- Cl AI <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAWS-RAINLEADERS METAL FIREPLACE F.CHIMNEY _ <br /> SINK SERVICE-BAR.ETC I <br /> 1 Pool Drain 2 00' <br /> 1 Skimmer 2 00 <br /> 1 Recycling Unit 2 00 <br /> SUB TOTAL 6_ _00 SUB TOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE S 6 00 TOTAL FEE S <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 6' 20' 20' J 79/6755 FEE 46.00 RECEIPT NO <br /> USE ZONE LOT AREA VACANT SITE 43319 <br /> R-1 LI YES tetWO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO OF DWELLING UNITS <br /> V-N R-3 1 BUILDING 519,340.00 92 00 <br /> SIZE OF BLDG. NO.OF STORIES MAX OCC.LOAD <br /> 23'6"X35' 1 PLUMBING 6 00 <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> 3 REGUIREQv MECHANICAL <br /> !I YES rTR0 <br /> APPROVALS BY DATE OTHER <br /> I. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> 2 BUILDING PLANS SEC.303(a) <br /> 3. FIRE HYDRANT TOTAL 98 00 <br /> 4 FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> -.., WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5 GRADING O., /�n <br /> 0. DRAINAGE -< 14.4 -. 3 1 7 1 7 $097 U.U '- <br /> _7 ENVIRQF1t9EF1}AAL IMPACT STATEMENT <br /> o , HEALTF4 1 QCT l'.." CO <br /> APPLICAT(0 ACC BY NS CHECKED BY APPR.FOR ISSUANCE BY YO U R REC E I PT <br /> rrT <br /> V.C. ' ; THANK YO U <br /> '+m •• -'y <br /> 1 <br /> `� ADDRESS FILE 18 OCT 7' <br />