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�he Evergreen �" <br />CITY OF <br />Q <br />Cf'`NSTRUCTION <br />everett PE�M�Y PERMIT N0. O6H%Z <br />CITY HALL 259�8745 <br />EVERETT.WA 98201 ❑ COMB!NATION ❑ BUILDING ❑ MECHANICAL ❑,PLUMBING <br />OWNER MFILAOORE55 CITY ZIP PHONE <br />'.� D R�ckettG 6�91 F1Pmine RA_ F.cr ra+i- qA9n� �.5i 1436 <br />ARCHITECTORDESIGNER MAILAD� E55 QTY ZIP PHONE <br />Self <br />GENEflALCONiRHGTOR MAILAODRE55 CITY ZIP PHONE LICENSE/ <br />Self <br />MECHANICAICONiFFCTOR AIAILAODR[55 CIiY ZIP PNONE LICENSE� <br />None <br />PLUMBINGCQNiRACTOF MAILADpPE55 CIiY ZIP PHONE LICENSEI <br />V~VV V ❑NEW �ADDI110N ❑ALTERA710N ❑REPAIR ❑DEMOIIiION OFENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK . <br />S 100�.�0 <br />�ESCRIBE WORK <br />LEGAL DESCRIPTION OF PqpPERTY �SHOW <br />�or 35 B�a�_oF �€ <br />� <br />Northerly 35 oi <br />House is on lot <br />,InB A�DRE55 <br />�6321 F1PminQ� <br />PLUMBINO <br />NO. TYPE OF FI%1 <br />WATER CLOSET (TOILE7) <br />BATHTUB <br />LAVATOflY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />UIUNDRY TRAY <br />CLOiHES WPSHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEAD <br />SINK 15ERVICE — BAR. ETC. <br />SIDE YARD <br />TYPE OF CONS <br />V-N <br />SIZE OF BLDG. <br />IOX25 <br />LOT AREA <br />M-1 <br />1. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEN � <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT S7ATEMENT <br />B. HEALTH DISTflICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />�EE <br />REAR VARD SETBACK <br />VACANT SITE <br />LlYES L7N0 <br />N0. OF DWELLING U1 <br />MAX.00C.LOAD <br />APPR.FORISSUANCE BV <br />I HEREBY CERTIFY THAT I HAVE READ AND EYAMINED 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 CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF �ONSTRUCTION. <br />SIGNA7URE OF CANiRAGTOR Ofl PUiNORIZED AG:NT DATE <br />X /YI .Q .�N.� J �L.U.� ZO�ZJ�/J <br />MECHANICAL <br />NO. TYPE OF EUUIPMENT FEE <br />AIR COND. UNITS — H,P. EA. � <br />REFRIGEFATION UNITS — H.P. EA I I <br />BOILEPS — H.P. EA. <br />GAS FIRED A.G UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M <br />SVALL H[ATERS — B.T.U. M <br />UNIT HEATERS — B T.U. M <br />EVAPORATIVE COOLERS <br />CLO7HE5 DRYERS <br />VENTILATION FAN <br />RANGEMOOD <br />AI(] HANDIJNG UNIT — C. <br />TOTAL FEE <br />N CHECK NUMBER <br />FEE <br />6872 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTV <br />TOTAL <br />$1 <br />n <br />U.B.C. <br />SEC. 303 (a) <br />RECEIPT N0. <br />FEE <br />VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />s9�� so ra.�o ��., <br />� <br />.YQU�R f�E'QElPio = <br />� rr`-ir�r�K �r;ou ' <br />ADDRE55 FILE 2 3 �T '74' , � �'_f <br />