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u � �� v�� � -. _ <br />everett PERMIT pERKAIT PIO.OH59O <br />CITY HALL 259�8745 <br />EVERETT.INA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL PLUMBING <br />MAIL AUDPE55 GITY ZIP PNONE <br />�';:':�" 98203 252-1569 <br />Dale R. Pope 4915 Dogwood Drive �TY Z�P PHONE <br />ARCNITEGT OR �ESIGNER MAIL A��JAE55 <br />GENEHALCONTflAGiOfl MAILAODRESS CITY ZIP P��ONE LILENSEI <br />S ame Z�p PMONE LICENSE � <br />AIECMANICAL GONTRAGTOR MAIL AODPE55 GTV <br />MAILADDRE55 CITY Z�P PMONC UGENS[� <br />PLUMBING GOMf1ACTOR . <br />❑NEW ❑ADDITION ��TEPATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />f 1,200.00 <br />DESCRIBE WOFK <br />interior remodel <br />PPOPoSED USE OP BUIIDING <br />single family residence <br />LEGAL DESCRIPTION OF PROPERTY ISNOW BEIOW OR ATTACH WUR CA°IE51 <br />ior 44 e�aK_oF Forest Park Div <br />PLUMBING <br />WA1 <br />VACUU <br />nwr vnnn.o — <br />SINK ISERVICE — <br />SIDE YARD <br />USE <br />Dr <br />STREET SETBACK I REAR <br />LOT <br />t. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PRO7ECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALIN DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />A ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERIJIT 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 CONSTRUCTION. <br />SiGNATUBE OF � �� � OAiE <br />! <br />v � ss'��� �/� �' ll�18�8� <br />SETBACK <br />❑YES L]NO <br />PJ::1 <br />MECHANICAL <br />NO. TYPE OF E�UIP <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. <br />OOILERS — H.P. EA. <br />GAS FIRED A C. UNITS — TONI <br />FORCE� Alf' SYSTEMS — B.T.I <br />Wq�� HEATERS — � T.U. <br />UNIT H[ATERS — �.T.U. <br />FEE <br />FEES �A��AT� <br />BUILDING 51200. <br />PLUMBING <br />PENAL7Y <br />TOTAL <br />u.e.c. <br />SEC.303(a) <br />FEE <br />RECEIPT NO. <br />FEE <br />20 50 <br />6 00 <br />3 00 <br />29 50 <br />:nmu rnu....��..�. <br />iEN PFJPERLV VALIDATED (iN THIS SPACE) THIS IS YOUR PERMIT <br />— 3 a�3� �r2� Q � <br />�`,� <br />APPR.FORISSUANCE �Y ij <br />L.C. <br />� .. ',1 � <br />� <br />� <br />, . i;_� �; iPT <br />.. ..!�.li� �l�'��. U <br />I; �,cr 3 0 I R �;a� R o <br />ADDRESSFILE <br />