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� d�eEvergreen ^,ONSTRUCYIOlV � <br /> CITY OF <br /> everett p��M�T PERMIT N0. Og4O2 <br /> CITY HALL 259�8745 <br /> EVEFETT.WA 98201 ❑ CON;BINATION ❑ BUILDING ��ECHANICAL PLUMBING <br /> MAIL ADDPE55 <br /> GTY 21P PMONE <br /> ov,HEa 9 8 2 01 <br /> Pat Walker 2218 Lombard Everett <br /> ARGHRFCT OR DESIGNER <br /> MAILPDDRESS CITY ZIP PHONE <br /> MAR ADDRE55 <br /> CITY ZIP PHONE LIGENSE� <br /> G[NEqPLCONTRACTGR <br /> 61ECHANICAL CAN i fiAGTOR MFIL ADDRE55 <br /> QiY ZIP pHnNc �ICENSE e <br /> Natural Gas Equipmnet 1611 East Grand cEverett 98201 Z P ONB 441 ucer�se� <br /> PLUMBING CGNTRAGTOF MAIL ADDRE55 <br /> GtAS50F WORR <br /> ❑NEW ❑FDDITION ❑ALTERATION ❑FlEPAIR ❑DEMOLITION ❑FENCE ❑SIGN GARAGE <br /> VALLIATION OF WOFK <br /> � <br /> 8 <br /> DESCRIBE WORK <br /> PFOPOSED USE OF BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �ecs�ueseaiFnor+oFrnoaearrisHo�ueeio�vonnrrncHFouacoaies� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> or � ��_oF . TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTIIJG 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 CONSTRUCTION. <br /> SIGNAT RE OF CJNiRAGTOR OR AUTHORIZEU AGENi DATE <br /> �oenoorEss X IIv L _ �� ,v 6/19/81 <br /> 2218 Lombard t�� <br /> MECH IJICAL <br /> I PLUMBING FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE N� �iR CONo. U YPS OF p�AIPMENT <br /> WATER GLOSET(TOILF.T) <br /> REFRIGERATION UNITS—H.P.EA <br /> _ BATHTUB B01'.:RS—H.P.EA. <br /> IAVATORY�WASH BASIN) <br /> _ GAS P�RED A.C.UNI1S—TONNAGE EA. <br /> SHOVlE�� FORCED AIR SYSTEMS—B.T.U. M EA. <br /> KITCHEN SINK&DISP. M <br /> V✓ALL HEATERS—B T.U. <br /> DISHWASHER _ UNITHEATERS—RT.�. �"� — <br /> � LAUNDP.Y TRAY <br /> EVAPORATIVE COOLERS <br /> CLOTHES WASHER CLOTHES DRYERS <br /> WATER HEATER VENTILATION FAN <br /> ' URINAL RANGE HOOD <br /> DRINKING FOUNTAIN GF.M. <br /> AIR HANDUNG UNIi— <br /> � FLOOR DRAIN STOVE <br /> VACUUM BREAKERS <br /> ROOF DRAINS—RAINLEADERS <br /> METAL FIPEPLACE&CHIMNEY <br /> SINK�SEf7VICE—F7AR.Ef�.� <br /> i <br /> Sll4 TOTAL S <br /> — SUB 70TAL pERMIT S <br /> PERMI7 S TOTALFEE 5 � 50 <br /> '� TOTALFEE S <br /> PLAN CHECK FEE <br /> SIDE 1'.\HD 52TBACK STREET SETBACK REAP YARD SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> 'i 7YPE OF CANST. OCCU°FNCY GROUP NO.OF DWELLING UNITS <br /> ( BUILDING S <br /> SIZE OF BLDG. NO.Of STOHIES MAx.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPFINf4ER5 MECHANICAL 7 S O <br /> REOUIRED <br /> �YES GNO <br /> qPPltOYALS <br /> BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2. BU!LDING PtANS TOTAL 7 S 0 <br /> 3. FIRE HYDRANT <br /> PERMIT VA�IDATION <br /> 4. FIRE PROTECTION 5YSTEM WHEN PROPERLY VALIDATED(W THIS SPAC�)JHl$IS YO�lR�PC'JPAMT 5 n � � <br /> � � N - <br /> 5. GRADING � <br /> G. DRAINAGE , Cr <br /> i <br /> 7. ENVIR�NMENTAL IMPACT STATEMENT � . . � �� <br /> B. HEALTII DISTRICT . , . �Q <br /> J <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR IS5UANCE[3Y <br /> � _. �� :� '�t �., � . <br /> _ G <br />