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L <br />rheEvergreen ^� y���1'��IO�� \' <br />c�rvoF V V <br />everett PERMIT pERMIT NO. 11Z35 <br />CITY HALL 259�8745 <br />EVERETf, WA 98201 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBINO <br />OWNEP MAIIADDRE55 CITY 21P PHONE <br />MARGARET JOHNSON P.O. ny 5529 FVERFTT aB206 252-0056 <br />APCHITECTOPOESIGNER MAILADDflE55 CITY 21P PHONE <br />GENERAL CONTRACiOR MAIL ADDRESS CRY 21P PMONE LICENSE I <br />MECMANICALWNTflACTOR MAILAODRE55 CITV ZIP PHONE UCENSEI <br />SELF <br />Ptl'MBUIGCONTRACTOR MnILADDRE55 CITY ZIP PHONE LICENSEI <br />LJNEW <br />R <br />VALUATION OF WOAK <br />E <br />�ESCRIBE WORK <br />INSTALL WOOD <br />PPOPOSEO USE OF BUIL�ING <br />IEGAL DESCRIPtION OF PROPERi <br />LOt BLOCN_OF <br />JOA ADDRESS <br />4015 FEDERA <br />PLUMBING <br />❑ADDITION ❑AITERAT10N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />�SMOW BELOW OR PTTACH FOUR COPIE51 <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILEfI <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUN�RYTRAV <br />CLOTHES WASHER <br />WATER H[ATER <br />URINAL <br />DRINKI.`1G FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAII <br />c�uv �ecavirc _ ano <br />SI�E YARD SETBACK <br />USE::ONE <br />TYPE OF CONST. <br />SRE OF BLDG. <br />FIRE ZONE <br />SETBACK <br />LOT AREA <br />NO.OF <br />1. ENVIRONMENTAL CHF.CK LIST <br />2. �UILOING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTEC710N SYSTEM <br />5. GRA�ING <br />6. DFAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH �ISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />lc <br />REAR YARD SETBACK <br />VACANT SITE <br />CIYES LINO <br />NO. OF DY/EILING UNITS <br />I HEREBY CERTIFY THAT I HAVE READ Ai:U EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />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 CANCELTHE PRO- <br />VISIONS OF ANY OTHER STATE OR LCCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTfiAGiOR OP FUiMORIZLU AGEI DATE <br />X //-��.4 �/�t 2eY-?.l� �i i �i i � � o � <br />MECHANICAL ✓ v <br />N0. TYPE OF EOUIPMENT -- FTEE <br />AI(i COND UNITS — H P EA I <br />REFRIGERATION UNITS — H.P. EA ._ �. I <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M <br />WALL HEATERS — B.T.U. M <br />UNITHEATERS-9T.U. M <br />EVAPORATIVE COOLERS <br />VENTILATION FAN <br />AIR HANDLING UNIT — <br />METAL FlREPLACE 8 <br />FEE I RECEIPT NO. <br />veniennN FEE <br />_ BUILDING $ <br />LOAD <br />PLUMBING <br />Y.LERS MECHANICAI. <br />!O <br />DATE OTViER <br />PENALTY U B.C. <br />SEC. 303 (a) <br />TOTAL <br />APPR.FORISSUANCE BY <br />1C <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />99S9 .SDI�.54-'` �' <br />N <br />YOUR RECEIPT � <br />THANK YOU <br />ADDRESS FILE <br />"—'I <br />i <br />� <br />