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tlte Evergreen �� N C'� R� C't I � r� .� <br />GTY OF V <br />eve�eit PERIUIIT PERMIT NO. 09009 <br />CITY HALL 259�87"�5 <br />Eveaerr.wn sem� ❑ COMBINATION �BUILDIWG ❑ MECHANICAL PLUMBING <br />OWNER MAILAO�FE55 CITY ZIP PMONE <br />John J. DeWispelaere 5824 Lowell Road Everett 98203 355-2594 <br />ARCMRECi Ofi DESIGNER lAAIL AO�RE55 CITY ZIP PNONE <br />GEN[PFL WNTRNCTOR MAIL ADDRESS CITY ZIP PHONE LICENSE � <br />Same <br />MECHANIGALGONTPACTOR MAILADDRESS CITY 21P PHONE LICENSEI <br />PLUMBINGGONTRAGiOF IdN�.ADDPE55 CRY ZIP PHONE UCENSEY <br />CL�E.S <br />❑NEW <br />4 <br />DESCRt9E WORK <br />re-roof <br />❑ADDITION ❑ALTERATION }�REPAIR ❑DEMOUTION �FENCE GiIGN ❑GARAGE <br />comgosition <br />single family residence <br />:[GAL �ESCPIPTION OF PROFEATY (SMO'N BELOVJ OR PTTACH FOUfl <br />�or 5 e�ocK 4 oF Laurel Height <br />5824 Lowell Road <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTU� <br />LA'/AiORY (IVASH BASIN) <br />SHOVv"R <br />KITCHEN SINK 8 DISP. <br />DISHIVASHER <br />LAUNURY Tr7AY <br />CLOTHES YJASHER <br />WATER HEATER <br />URINAL <br />DRINKIN3 FOUNTAIN <br />FI OnR DR�IN — <br />ROOF <br />SIDE YARD SETBACK <br />USE <br />TYFE <br />- ItHI1VLLMVCf�J <br />— BAR,ETC.) <br />SUBTOTAL <br />PEPMIT S <br />TOTHLFEE S <br />STFEET SETBACK REAR' <br />LUT AREA , +„�A� <br />❑YES <br />OCCUPFNCY GROUP NO.OI <br />NO.OF STORIES h��� � <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PIANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSiEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8. HEAITH DISTRICT <br />APPLICATION A(..;. 8V PLANS CHECKED BY <br />SF78ACK <br />UNITS <br />APPR. FOR ISSUANCE 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 />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMFLIED WITH WHETHER SPECIFIEG <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PAESUME TO GIVE AUTHORITY TO VIOLATE OR CANCFL THE PRO� <br />VISIONS OF ANY OTHER STATE OF LOCAL LAW REGULATING <br />CONSTRUCTION OP, THE PERFORMANCE OF CONSTRUCTION. <br />SiGy� URE�PF CONTfi� TOR 0 PVTNORIZ U AG[NT OH•E <br />..C��'. ���• if l., /,��,c ����.�. 3/ 18 / 81 <br />MECHANICAL <br />WALL <br />AIR <br />PLUMBING <br />MECHAIJICAL <br />OTHER <br />PENALTY <br />7YPE OF EC <br />). UNITS — H.P. I <br />iATION UNITS — <br />— H.P. EA. <br />DAG UNIT: —� <br />AIR SYSTEASS — <br />ATERS — B T.U. <br />�TFRS — R T ll. <br />& <br />EA. <br />M EA. <br />M <br />70TALFEE <br />PLAN ( <br />FEE <br />VALUATION <br />� ���.�0 <br />U.B.C. <br />SEC.303�a) <br />FEE <br />RECEIPT NO. <br />� � 1 <br />� � 1 <br />PROPERLY VFLIDATED (IN THIS SPACE) THIS IS YOUR PERMIi <br />5!:!:S ���C."0— b <br />� <br />� <br />, � n, �:'': IP7 � <br />, ',' . U <br />, .I <br />