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..r ;�:t7'�+�. <br />dieEvcrgreen ''y``1 C�NSTRUCTION �'�' ,�+ <br />CITY OF <br />everett PERMIT pERMIT NO. 09073 <br />CITY HALL 259�8745 <br />evEaen.v+n 9ezoi ❑ COMBINATION �CBUILDING ❑ MECHANICAL PLUMBING <br />OWN6R <br />MAILApDHE55 Cltt Z�o VMONE <br />Gary W. Ward 4831 Dogwood Everett 98203 252-3249 <br />APCHIiECI0RDE51GNER MAILADDRE55 GITY ZIP PHONE <br />GENERRL CANTqACT011 MAIL ADORE55 pTY 21P PHONE LIGENSE I <br />Same <br />MECHANILALCONiRACTOH MAILAODRESS QTV ZIP PNONE LICENSE� <br />PLUMBMGCONTR�GTON MAIUOORESS GIIY ZIP PMONE IICEN5E1 <br />55OF WOPK <br />❑NEW ❑ADDITION ❑��TERAiION ❑REPAIR ❑DEMOUTION ❑FENCE ❑SIGN GAFIAGE <br />UAiION OF WONK <br />s 900.00 <br />;cnioe woaK <br />4'6"x70' Retaining wall ____ <br />single family residence <br />LEGA� DESGFIPTION OF PPOPERTV (SMOW BELOW OR ATTACN fOUR CAPI[5� <br />pt�gf 53-S�aK_oF Forest Park Div. A <br />4831 Dogwood Drive <br />PLUM8ING <br />N0. TYPE OF FIXTURE OR ITEM <br />��GI77 <br />\NATER <br />— -7— _ <br />I <br />SIDE YARD SETBACK <br />USE 20NE <br />TYPE OF CANST. <br />SIZE OF BLDG. <br />4'6"x70' <br />FIRE ZONE <br />—BAR, ETC.) �. <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />�TqELT SETOACK <br />_OT AREA <br />OCCUPANCY GR( <br />lietaining <br />L ENVIHOIIMGNTALCHECY.'_i:.T <br />2. BWLDINGPIANS <br />3. FIRE HYDRANT <br />4. FIRL PROT[�TION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMEN7ALIMPACTSTATEMEN7 <br />� fiFn�Tt{ oisrmr.T <br />_ , - <br />FEE <br />REAR YARD <br />L]YES <br />NO.OF <br />i HEREBY CFRTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLIC4TION AND KNOW THE SAME TO BE TRU[ AND CORRECT. <br />ALL PROVISIONS OF LAWS A(JD ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE i.OMPLIED \NITH WHETHEF SPECIFIED <br />HEREIi� OR NOT. TIiE GRANTING 0'r A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE �R CANC[L THE PRO� <br />VISION�' OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTR!JCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUREG�C iRnCTOFORAUTHORIZE /•GENT OI.IE <br />Y t '.��� �1.���� — 4/13/81 <br />� tl. <br />MECHANICA� <br />N0. TYPE OF EOUIPMEMT FEE <br />n�n!`l1AIf� IINITS—HP FA. �— <br />itFMIbt11I111Vn vnuo— n <br />301LERS — N P.EA. <br />3A5 FIRED A C. UNITS — TONNAGE EA. <br />FORCEO AIR ::YSTEMS — B.T.U. M <br />VJALL HEATER9 — B T.U. M11 <br />UNIi HEATEI7S -- BSL. _�� <br />EVAPORATNE CC�OLERS <br />CLOTf{ES DRVER` <br />VENTILATION FAN <br />RANGEHOOD <br />AIP HAN�LING UNIT — C <br />S70VE <br />A.IFTAL FlREPLACE 8 CNIMNEV _ <br />SETBACK PLAN CNECK NUMdEH <br />9073 <br />E <br />�p FEES <br />ELLING UNITS <br />dui�oiNc <br />LOAD <br />PLUMBING <br />KLERS MECHANICAL <br />� <br />DATE OTHER <br />PENALTY <br />TOTAL <br />1L FEE <br />PU1N CF <br />FEE 10.40 <br />§ 900. DO <br />U.B.C. <br />SEC. 303 (a) <br />53115� <br />9 �1 <br />� �� <br />rcmm� ....�..... .��. <br />WHEN PROPERLV VALIDATED UN THIS SPACE) THIS IS �O�IR PERMIT <br />,,:� �,��i(.0C- � <br />� <br />� <br />� `: I G <br />