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1hE Evergreen � �NSTRUCTIO� • <br />CITY OF <br />everett PERMIT pERMIT N0: 06987 <br />CITY HALL 259-8745 <br />EVERETT. WA 9�m, ❑ COMBINATION � BUILDINO ❑ MECHANICAL ❑ PLUMBINa <br />OWNER N>ILADDRESS CITY ZIM VNONE <br />Nellie 9nsch 2025 Fairfax 98201 <br />ARCHITECTOFDESIGNER MNILAODRESS CITY ZIP PHONE <br />GENERALCONTqACTOR MaI�AODflESS CITY 21P PHONE LICE115E1 <br />Frank Westhaver 28700 SRS Stanwood 98292 629-4443 <br />MECHPNICFL GCNiRACTOR MAII ADORESS QTY ZIP PHONE LICENSE I <br />FR AN KW G227QR <br />PLb6:91NGC�NiPACTOR MAI�ADORE55 GiY ZIP PHONE LICENSE� <br />CL455 CF WOFH <br />❑NEW C��DDITION ❑ALTERATION ❑REPAIR COEMOLITION OFENCE ❑SIGN ❑GA(7AGE <br />VA! UATION OF WORH <br />y 5000.00 <br />10'x15' addition to existing single family residence <br />VFOPOSED USE OF Bl11LDING � <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINFD THIS AP• <br />PLICATION AND KNOW THE SAME 70 BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL 9E COMFLIED WITH WHETIiER SPECIFIED <br />HEREIN OR NOT. TI1E GRANTING OF A PEHMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />COIJSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAiUFE 0� CONiRAGTOR (lP PU%iH �RIZED AGEN�T OATE <br />X ��-.-�,,� o� ,, �_, /_ •'o ,�. / / -� R -7 <br />M°CHANICAL <br />LEGFL DESCWPTION OF PPOP[RiY �SNOW BELOV! OR ATTFGH FOUfl COPIES) <br />�or_$ eioc� 10oF _ Laurel Heights <br />2025 Fairfax <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />v <br />� <br />SUB TOTAL <br />YARD SETBACK � STREET SETBACK <br />USE ZONE LO7 ARE4 <br />TYPF.OFCONST. OCC�PANCY <br />V-N <br />512E OF BLDG. NO OF 5T01 <br />10'x15' Addition <br />FIRE ZONE I� BASElAENT <br />3 <br />APPROVALS <br />1. ENVIROIJMENTAL CHECK LIST <br />2. [3U�LDING PLANS <br />:i. RRE HYDf1ANT <br />4. FIRE PR�TECTION SYSTEM <br />9, GRADING <br />b. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATF.AIEN7 <br />REAR YARD SETBACK IPLAN <br />_1vES ❑NO <br />GROUP NO.OF DWELLING <br />R-3 1 <br />IIES IAA%. OCC. L04D <br />1 <br />DATE <br />8. HEALTH DISTRICT I I <br />APPLICATION ACC. BY PLANS CHECKED BY I APPR. FOp ISSUANCE BY <br />v.c. <br />TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H P. EA <br />BOILERS — HP. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FOFCED AIR SYSTEMS — B.7.U. M <br />WALL HEATERS — BS.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPORATNECOOLERS <br />VEN i ILATION FAN <br />RANGEHOOD <br />AIR HANOLING UNIT — CF <br />STOVE <br />MFTAL FIREPLACE 8 CHIMNEV <br />TOTAL FEE <br />rtt <br />ggg�� I FEE 1( , QQ I FECEIPT N0. <br />45356 <br />FEES VALUATION F�E <br />BUILDINU s5,000.00 32 00 <br />PLU�dBIMG <br />MECHANICAL <br />OTHER <br />PENALTY U.B.C. <br />SEC. 303 (a) <br />TOTAL 32 00 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDA'fED (IN THIS SPACE) 7HI5 IS YOUR PERMI7 <br />523b �031.�0 --� � <br />�. <br />1 � � � <br />YO`U`R RECEIPT o <br />' TH,�NK YAU . � <br />' � � <br />.� �„ � +. 8�► 7 9 <br />