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l� <br />L <br />IheLl�er,l'reen ;. ^ONSTRUCTIO�' <br />U1v O� <br />everett ' <br />CITYHALL259-8745 PERMIT PERMITNO. 144DE� <br />EVERE7T, WA 98201 � CQMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />t MAIL F�ORE55 CIiY ZIP PMONE <br />LYNNUS IMHOLT 7220 DEVERLY LANE E ER TT 1:A Q8203 aFa_g2�� <br />ARCMRECt OR �ESIGNER MAIL ADDi�E55 CIiY ZiP PNONE <br />GENEFAI CONTRRGiOR MPIL ADpRE55 CITY ZiP PHON[ LICENSE / <br />DAMAGE REPAIR SERVICE BOX 2045 EVERETT WA 9820� _337-42 �aAm <br />MECHANICRL GONiRACTON MRR ADORE55 C�iY ZIP PHONE LICENSE 1 <br />PIUMBING GONiPAGiOR MAIL ApDRE55 CItY 21P PMONE UCENSE � <br />GLASS OF WORN - <br />❑ NEW ❑ ADDITION ❑ ALTERATION �qEPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />VALUATIOr�N OF WORK <br />S �G�Q.�O <br />re damage repair <br />Residence <br />LOi__BLOCH_OF <br />Beverly Lane <br />PLUMBINO <br />N�. TYPE OF FI%TURE OR ITEM <br />WAT ER CLOSET �TOILEp <br />BATHLUB <br />LO.VATOflY�WASH BASIN) <br />SHUWEN <br />KITCHEN SINK d DISP. <br />DI:iHWASMER <br />LPUNDRV7RAV <br />CLOTIIES WASHER <br />N'AiL'R HEATEH <br />URINAL <br />bRINKING FOUNTAIN <br />I'LOOR DflAIN <br />VACUUM BREAKERS <br />HOOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAH, ETC.) <br />�.UB TO7AL <br />PEAMIT <br />fOTAI FEE <br />SI7.E OF <br />FIRE IONE <br />1 EI:7�'nviri.ici.inL�n[Lnu�1 <br />1. [3UILDING PLANS <br />]. FIRE HYDRANT <br />d. PIPE PROTECTIOH SYSTEM <br />5. GRADING <br />6.ORAINAGE <br />7. ENVIflONMENTAL IMPF,CT STATEM1 <br />B. HEALTM OISTRICT <br />APPLICATION ACC. OV PLANS <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF N10fiK !NI! L BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR �OT. THE GRANT�NG OF A <br />PERMIT DOES NOT PRESUME T6 GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE ! ROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGN�jJRE OF LONTHAGiOR OF AIITHORI2ED AGENT DATE <br />X <br />MEi <br />N0. <br />i <br />S <br />f <br />REAR YARO SETBACN PLAN <br />VACANT SITE — <br />1'ES NO <br />MA%. OCC. <br />YES NO <br />I� <br />TYPE OF cOUIPMENT <br />AIR COND. UNRS — H.P. EA. <br />REFRIGEFATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA, <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS —� B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR MANDLING UNI7 — C.F.M. <br />S70VE — WOOU <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL f <br />PERMIT f <br />TOTALFEE f <br />( NUMBEli PLAN C <br />FEE �FEES VqLUAT10N <br />�UILOING <br />PLUMBING <br />MECMANICAL <br />OTHER <br />PENALTV <br />U.tl l: <br />SEC.307 <br />FEE <br />RECEIPT NO. <br />FEE <br />rora� 20 50 <br />PERMIT VALIDATION <br />WHEN PROPERLV VALIDATED pN THIS SPACE� THIS IS YOUFPERMR �; <br />_ i �� � <br />_ r'� <br />�._ 1. <br />�J <br />� � <br />BY <br />��!)DI:!St� Illi <br />� <br />w� <br />• <br />