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—r <br />the ErcigmoF ._ V'� � V� � � �� � � � - <br />evereti �ER��� PERMIT iVO. U�67H <br />CITY HALL 259�87A5 <br />EVERETT, Y!A 98201 ❑ CC�MBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OYJYER MAILAD08E55 CIiY ZIP PHONE <br />U-Haul Co. Of Wetern Wa. Seattle 9b194 682-0333 <br />ARGHIiECT OR DESIGNER MA4 AOORE55 CIiY ZIP PMONE <br />GENERALCONTRALiOfl MAILADDPE55 CITY 21P PHONE LICENSEI <br />Sam� <br />MECHANICAL CONTRACTOR M�II A00PE55 CITY 2IP FMONE UCENSE Y <br />PLUM�INGCONiRACTOB A�AILA��(�ESS CITY ZIP PMONE UGENSE� <br />❑NEW ❑ADDITION �XLTERATION ❑REPAIR ❑DEMOLITION ❑FENCE CSIGN ❑GAfiAGE <br />VAIUATION OF WOPK <br />56����.�� <br />DESCRIBE WOflK <br />interior remodel <br />LEGAL DESGRIPTION OF PROPERTY (5410W �EL014 OR ATTACH <br />�or 1S-16BLOC�_OF BeverlV F <br />J00 AD�RE55 <br />6443 Evergreen T9ay <br />PLUMBING <br />NO. TYPE OF FIXTI'RE OR ITEM <br />BATHTUB <br />DRINKING �OUNTAIN <br />BREFKERS <br />41N5 — RA <br />virc — ae <br />S!�E YARD SE7BACK STREET SETBACK <br />USE ZONE LOT AREA <br />TYPE OF CONST. OCCUPANCY GRC <br />SIZE OF BLDG. NO.OF STORIES <br />FIRE ZONE BASCMENT <br />1. ENVIRO::MENTALCHECKIIST <br />2. BUILDING PIANS <br />3. FIRE HYDRANT <br />4. FIRE?ROTEC710NSYSTEM <br />5. GRADING <br />6. �RAINAGE <br />7. ENVIRGNMENTALIMPACTSTATEMENT <br />b. HEAL7H DISTRIC7 <br />APPLICATION ACC. 6Y PLANS CHECKED BY <br />��. <br />FEE <br />REAR YARD SETBACK <br />❑VES ❑NO <br />UNITS <br />� HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS AP� <br />F'_�CATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GO'lERNING THIS <br />TYPE OF WORK WILL 6E COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIO� OTE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER TE LOCAL LAW REGULATING <br />CONSTRUCTI N OR THE ERFORM. CE OF CONSTRUCTION. <br />ONATL°OF�C�IRACTpR(CLi-<IjT 09±2ED' cNT,� DATE <br />NO. TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERA710N UNITS — HP. EA <br />BOILERS — H.P. EA. <br />GAS FIRED AG UNITS — TONNAGE EA. <br />FJRCED P.IR SYSTEMS — B,T.U. M <br />WALL HEATERS — B.T U. M <br />IINIT HFATFRS _ P: II M <br />ES DFVERS <br />RANGEHOOD <br />STOVE <br />80/7678 <br />�UILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />APPR. FOR ISSUANCE BY I � <br />FEE <br />SUBTOTAL 5 <br />PEqM1T S <br />70�AL FEE 5 <br />PLAN CHECK FEE <br />PEE 23.40 RE4tl�`JltlO. <br />VALUATION FEE <br />$ 6,000. <br />U.B.C. <br />SEC.303(a) <br />� � �' <br />�� �f <br />PROPERLY VALIDATED (IN THIS SP'G9 7 9 IS YO�R PE? O. a O � I <br />L Qu <br />� � <br />i.� <br />`?O�.1P. RECEIo <br />r�-i�r.•.R vou <br />- 3 s��, sa <br />ADDRESS �ILE '' <br />