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Ihr E�r�Arrrn �fl N ST R U CTI O N <br /> � 'TY UF <br /> everett iP'ERMIT PERMIT NO. Og168 <br /> CITV HPLL'1ni10M5 <br /> ivEnerr wn ��eao� ❑ COMBINATION �� BUII.DING ❑ MEi,HANICAL ❑ PLUMBING <br /> OYltll{i MAIL \I�Jllt.'�.� (�'IfY )I�' <br /> ri�or+� <br /> Der.nis H. (Gray) Rogers 15018 64L-h N.E . Lake Stevene 98158 691-6259 <br /> >r�omccr on uis�cr�i i� Mn��.00n�ss crtv zir vrror+t. <br /> r.ir�tneicovrq.cron uuiannnrss arr � zir m�oNe uc[r�s[r <br /> Same <br /> utCr�4WCqLCONiR�CtOR unILRDDRE55 �IiY )IP MONE IICENSE� <br /> �'L�MpINGCONTRACTOR 1UilAD�RE55 Liiv LiP pHONE !iCENSE� <br /> CLNSS Of WORN — — <br /> �NEN� ❑ADDI710N ❑ALTERATION L�REPAIR }�]DEMOLITION ❑Fc4CE ❑SIGN ❑GARAGE <br /> VAWALIONO�WORN <br /> 3 <br /> D[SC919E WORN <br /> Demolish single family residence <br /> raoroseo use or nmimNc — — — <br /> I HEREBY CERTIFY iHAT I HAVE READ AND EW.N�INED THIS AP� <br /> irceiocsenianoHorraorca�.is�wwneiuwon�irea�rouemvrtsi PLICATION AND KNOW THE SAME TO BE TRUE ANb CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDI�JANCES GCVEPNING THIS <br /> 1Oi 01�K-0° TYPE OF WORK WILL BE CO�APLICD WITH WHETf IER SPEGFIED <br /> Sec. 13 28 4 HEREIN OR NOT. THE GRANTING OF A PERMR COES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE I'RO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULAIING <br /> COMSTRUCTION OR THE PERFOPMANCE OF CONSTRUCTION. <br /> JOB Aof]RFSs Si,Nnipnl Or�puirt4C�(n�nn nu"a Wi11 n n,�Nt pntt <br /> _ 7 Weet Caeino Road X 4/23/81 <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMEN7 FE.E <br /> wqrea aoset iroaeti n�n eoNo uNirs—��r �n <br /> BATHTUG HEf111GERATIO�:UNITS— H P EA <br /> lAVA709Y(WPSN BASIN� BOILLHS—H P EA <br /> SHOWER G�S I INCD A C UNI1S—TONNAGF EA <br /> NITCHEN SINN 6 DISP FORCED AIR SYST[MS--B T U M EA <br /> UISHWASNER WALl1�EAiEfi5--I1T.0 M <br /> LAUNDRV TRAV LNIi FEAT[IiS—f3T U M <br /> CIOiHES WASNER EV����JRATIVE COOLERS <br /> WATER HEATER CIOTNCS D�YERS <br /> UI7INAL VENi1LATIUN FAN <br /> DRINKING FOUNTAIN RANGG HWD <br /> FLOOR DRAIN AIR IIANDLING UNIT— C F M <br /> VACUUM BREAKERS STOVG <br /> ROpF URAINS—RAINLEADERS METAL RFEPLACE d CHIMNEY <br /> Si4K BEHVICE—BAR,ETC! <br /> 6UB TOTIIL SUB TOTAL 3 <br /> PERMI7 f PERMIT f <br /> T0TI1L FEE i TO�AI FEE f <br /> SIDE YARD SETBACK STR[Ei SETBACN fiEAR VARD SETDACK PLAN CHECK NUM[lEP P1AN CMECK FE[ <br /> FCE RECEIPT NO <br /> USE ZONE LOT AHEA VACANT SITE <br /> i7YE5 ;INO F�C6 VALUATION FEE <br /> TVPE OF CpNS' OCCUPANCV GROUP NO OF DWELLING UNRS <br /> BUILDING f OO OO <br /> SIZE OF BI.DG NO OF STORIES MA% OCC LOAD _ <br /> PW MBING <br /> FlpFZONE BASEMENT FlRE SPRINKLERS — <br /> REOUIRED MECHANICAL <br /> iIVES i�NO <br /> APPROVALS BV DATE OTNER <br /> 1 ENVIRONMENTAL CHECK LIST U P C <br /> _ PFNALTV S6G 3UiIn1 <br /> 2. BUILDING PlANS _ <br /> 3 fIREHYDRANT T�TA� OO OO <br /> d FlPE PROIECTION SYSIEM PERMIT VALIDATION <br /> 5 GRADING W�iLN PqOPEnLV VAUDATE[1�IN THIS SPACE)THI515 VOUIi PERMIi <br /> 6 ORAINAGE � t ' , � ' � � � <br /> I <br /> � ENVIRONMENTALIMPACiSTATEMENT �--� <br /> B MEALTII DISiRICT � <br /> AAPLICAiION ACC BY PU+NS CHECNED BY APPR FOR ISSUANCE BV � � I � <br />