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rl L`LrtrLC„ � CONSTRUCTION � <br />CI7Y OF <br />everett PERMIT PERMIT NC. On� <br />CITY HALL 259�if� :5 <br />veaert.wn �yzo� ❑ COMBINATION OtBUP..DING ❑ MFCHANICAL ❑ PWI'dBING <br />. .. : ;� rani� nuontss arv <br />ZiP PMOfJF <br />Gary L. Morrill 6132 Lombard Everett 98203 353-440h <br />�-�� �iiECT02DESat1Fq AIAILnDDHESS P1V <br />L� PHUNE <br />i.1�i9F��pNTflFCTOR MAI�NDDHF55 Cli� :;P pNONE �ICBbE� <br />Same <br />r. , i_,:pNICFI GCNiRhCtOP AI0.i1 ADpPE55 CrtY <br />ZiP PIIONE �ILENSE I <br />�:.UYfllflG CONTRACiOP AiAI� AOORE55 f.liY ZIP PHONE LICE1!$E I <br />_..` S UF WORN <br />❑NEW ❑ADDITION ❑ALTERAT'ON j{KREPA�R L�DEMOLIiION GFENCE ❑SION CGARAGE <br />U-LUATION OF WORK <br />900.00 <br />I;i'.-,niOE YtORK <br />re—roof shake <br />. � . ��L3cD UGE OF [3UiLDING <br />single family residence <br />.. .��-, oescnirnon ov vqoa[mv �siow nEiov: on nr*nc�� FouF r,or�ies <br />Ptn. 17-18 2 Pinehurst Div. �2 <br />i,�.r u�xK_oc <br />.�.-; ;, �; o��ss <br />6132 Lombar3 Avenue <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />DISHIVASHEH <br />LAl1NDRY TRAV <br />CLOTNES WASHE <br />WATER HEATER <br />URINAL <br />DRINKING FOUNI <br />FLOOR DRAIN <br />VACUUM BFEAKE <br />ROOF DRAINS — <br />cu.iv �ccA•nrc — <br />SIUE YARD SEiBACK <br />L15F ZONE <br />'� c OF CANSi. <br />SI: E OF BL�G <br />PEHMIT <br />70TAlF <br />STPEET SE <br />NYYXUVAI <br />1. ENVIRONMENiAL CHECK LIST <br />2 �UILDING PLANS <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />5. GRADING <br />n pRP,INAGE <br />�'�;'IRONMENTAL IMPACT STATEMENT <br />iN D 11 � <br />FEE <br />S <br />. HEREBY CERiIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION AND KNOW THF SAMc TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND O�D�NANCFS GOVERNING Ti iIS <br />TYPE OF WOFK WI�L BE COMPLIEC' WITH WHETHER SPECIFIFD <br />HEREIN OR NO7. THE GRANTWG OF A PErIMIT DOES NOT <br />PRESUME TO GIVE AUrHORITY TO VIOLATE OR CANCEL THE Pf�O� <br />VISIONS OF ANY O?HER STATE OR LOr'AL LAW REGULATING <br />CONSTRUCTION O�t THE PEHPORMANCE F CONSTRUCTIO�d. <br />SIG�IATUR6�OF,COHiRFROHOqpU N(Y.iIZECNGffI�:� OA;E <br />/ / <br />�/ 9/17 79 <br />X - i� �,. �1,:,� ,,,,�'= ir/,j,r' <br />NO. <br />REFRIGEPhTION UNITS —LHP EA <br />BOILERS -- H.P. F.A. <br />GAS FIRED A.C. UVITS — iONNAGE EA. <br />F'ORCED AIR SYSTEMS — B T.0 M EA. <br />WFLL HEATERS — OSL. M <br />UNI7HEATEFlS—BLU. M <br />EVAPORATNE COOLEFF <br />CLOTHES DRVENS <br />�IR HANDLING UNIT — <br />STOVE <br />A1F.TAL FIREPLICE 8 CF <br />AEAR VARD SF.T�ACK PLAN CHECH <br />VACANT SITE <br />f.'�YES CNO <br />NO. Of DWELLING UNITS <br />�UILDING <br />MAn OCC 104D <br />PLUIdBING <br />FIRE SPRINKLERS <br />REOUIRED MECHANICAL <br />f!VES .iNO <br />BY DATE OTHER <br />PENALTY <br />TOTAL <br />PEHMIT VALI <br />IVHEN PPOPE <br />i"': . PU+NS CHECKED �V I APN� �UR ISSUA�JCE BY <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />NUM6F�i PLAN C' <br />FEE <br />FEES VALUATION <br />s 400.00 <br />U.8 C <br />SEC. 303 �a) <br />RECEIPT NO. <br />YGt <br />5 �OD <br />I, I 5 00 <br />�TION <br />V VALIDATED �IN THIS SPACE) THIS IS VOUR PERMIT <br />2,s, sno�.00 ��, <br />:� ? <br />( <br />�ou� R£cEti�„ <br />-rr�a�x,Yca.�' <br />i <br />� �� \-.;; j' � .� <br />