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r <br />� <br />� <br />d,�ci•crvoF �'ONSTRUCTION = <br />�V�i,��� PE�M�� PERMIT NO. ZO434 <br />C�TY HAL! 259�0745 <br />eve�err. �on eeco+ ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />U�:RlLR ldAILADDPESS G�TY ZIP P11011c <br />Claytcn Bernard 5617 Lowell Road Everett 98203 353-3916 <br />;.Rc��ITECiOPDE5IGNER lAnILADDRE55 CIiY ZiP PHON[ <br />GELEiiAL WNiRAGTOR IAAILADDPE55 piV ZIP Pi�Of1E LICENSE � <br />Same <br />V[CHn�1iCALWNTRACTOR MRILADOAE55 qiY ZiP PHONE L'CENSE� <br />VLUTA�iY.GCONTFACTOR MAILADOflE55 Cliy ZIP PHONE LICENSE/ <br />CLASSG WORK <br />❑NEW ❑ADDITION ❑ALTEHATION ❑REPAIq ❑DEMOLITION ❑FENCE ❑SIGN ��ARAGF <br />V�LUATION OF Y/ORK <br />5 BrJ�.�� <br />D[SCRIBE WORK <br />erect car-port <br />PROPOSED USE OF DUILOING <br />DESCPIPTION OF PROPERiY �SMOP. �ELOW OR ATTACH FOUR GOPIES <br />4 9 __ Laurel Heights <br />JOB AOOFE55 <br />5617 Lowell Road <br />PLUMBING <br />NO. TYPE OF FI%Tl <br />DISHWASHER <br />' Al1NDRY TRAY <br />IRINAL <br />VA`:UUM BREi.KE <br />ROOF ORAVdS — <br />SINK ISERVICF — <br />SUBTOTAL <br />PEflM1T <br />SETBACK � STREET <br />USE ZONE <br />TYPE OF CONST. <br />V-N <br />SIZE OF BLDG. <br />460 Sq. F't <br />FIPE ZONE <br />M <br />NO. OF STOI <br />1 <br />BASEMENT <br />1. ENVIRONMENIAL CHEQ( UST <br />2. BUILDIN(i PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACG BY PLANS CHECKED BY <br />HWM <br />FEE <br />REAR YARD SETBACK <br />SITE <br />❑NO <br />DWELLING UNITS <br />��G{•;i:vq <br />APPR. FOR ISSUANCE BV <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION AND KNOW THE SAIJIE TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING 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 />CONSTRUCTIGN OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT �i OF �p!' RACTOR OR ' �OR12[D AGENT � GATE <br />� j�'�h � 4/20/82 <br />TYP[ OF E�UIPMtrvT FEE <br />AIR COND. UNITS — H.P. EA. <br />o[[vinooniinu � iwiS — N P FA <br />GAS FIRED A C. UNITJ — TONNAGE EA. <br />FORCED AIR SYSTEMS — B:f.U. �� <br />WALL HEATERS — B T.U. � <br />IINITHFATFRS—AT.LL � <br />ORYERS <br />AIR HANDLING UNIT — GF.1,1. <br />CHIMNEY <br />PERMIT <br />TOTALFEE <br />82/10434 I FEE 1�.4Q RECEIP7 NO <br />FEES VALUATION FEE <br />BUILDING S 850.00 16 00 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTV U B.C. <br />SEC.303(a) <br />TOTAL 16 0 0 <br />PERMIT VALIDATION <br />WHM PROPERLY VALIDATED (IN THIS SPACE) THIS IS VOUR PERMIT <br />ia6s $016.00—d1 <br />• M <br />�' <br />YGi1R REC[IPT� <br />i'i-IANK YOU <br />ADDRESSFILE <br />20hPa �2 <br />