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r <br />� <br />r <br />L <br />d+e Evergreeir r�Q N ST R U CT I O N�� �� <br />CITY OF <br />�verett PERNiIT PERMIT NO. 11663 <br />CITY HALL 259�0745 <br />EVEREi7. WA 98201 ❑ COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />X <br />OVMER IANILAUDflE55 GIiY ZIP PMOtlE <br />ROY E. ANDERSON 6601 LOMBARD AVE. EVERETT WA. 98203 355-5882 <br />ARCHIiECi0ipL51GNEF MAILADpPE55 LITY ZIP PMONE <br />GENERALCONiRAGTOR MAILADORESS GiV ZIP PNONE LICENSEI <br />l.fECHFMCRLCANTPAGTOR MAILADORE55 GiV ZIP PHONE LiCENSEY <br />PLUM1IBINGCONiRAGTOR GAILA�DRE55 CIiT ZIP PNONE IICENSE/ <br />SELF <br />❑NEW ❑AD�ITION ❑ALTERATION }Q]REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />E <br />IEGhL DESCRIPi10110F <br />LOI f3LOCK_ <br />6601 LOMHARD AVE. <br />PLUMBING <br />NO. TYPE OF FIXTI <br />WATER CLOSET (TOILFT) <br />BATHTUB <br />LAVATORV (IYASH �ASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — FAINLEADEF <br />SINK ISERVICE — BAR. [TC.7 <br />SIDE YARD SE7BACK <br />USE ZONE <br />STREETSETUACK <br />LOT AREA <br />OCCUPANCY GROUP <br />FEE <br />REAR YARD SETOACK <br />❑YES ❑NO <br />NO.OFDWELUN <br />MA%.00C.LOAD <br />APPROVALS BY OATE <br />1. ENVIPONMENTALCHECKLIST <br />2. BUILDINGPLANS <br />3. FIRE HVDRANT <br />4. FiRE PROTECTION SVSTEM <br />5. GRADING <br />6. ORAINAGE <br />7. ENVIRONMENTALIMPACTSTATEMENT <br />B. HEALTH DISTRICi <br />APPLICAiION ACC. B'! PLANS CHECKED BY APPR. FOR ISSUANCE BY <br />I HEREBY CERTIFY THAT I FIAVE READ AND EXAMINED 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 dE COMPLIED WITH WHETHER SPEGFIED <br />HEREIN OR MOT. THE GRANTING OF A f'ERMIT DOES NOT <br />PRESUME Tn GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REU'ULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTAUCTION. <br />SIG�lA7�ap O�F GON"T�Rl�GF�(1 OH AUTIIOFIZED AGENT DATE <br />%�'1�Cf J7'� kysv��/�J�i"Li= 4-4-83 <br />MECHAIGICAL <br />NO. TYPE OF E�UIPMENT FEE <br />AIR COND. UNITS — HP. <br />REFHIGeRAT10N UNI7S — <br />BOILF.RS — H.P. EA. <br />GAS FIREf. A C. UNITS — <br />FORCED AIR SYSTE1.15 — <br />WALL HEATEPS — B.T.U. <br />UNIT HEATERS — B.T.U. <br />EVAPORATIVE COOLERS <br />RANGEHOOD <br />AIR HANDLW( <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />ADDRESS FII_F <br />ii — <br />8 CHIMNEV <br />PERMIT <br />FEE <br />$ <br />M <br />PLAN CHECK FEE <br />I RECEIPT NO. <br />U B.C. <br />SEC.3o3�a) <br />�C <br />pN THIS SPACE) THIS IS YOUR PERMIT <br />530n $005.00 — � <br />� <br />YOU R RECEIPT � <br />1'F�.<�i�1K YOU <br />- � t,�� 8 3 <br />