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die Evergreen <br />GTY Of <br />everett <br />CITY HALL 259-6745 <br />EVERETT. WA 98201 <br />GC'ISTRUCTION <br />P'ElRMIT <br />❑ COfiABINATION � BUILDING ❑ MECHANICAL <br />L <br />PERMIT NO. O! 8O 4 <br />❑ PLUMBING <br />owrvea Mnanoneess "'� ggz03 353-3702 <br />i,eonard Rachel 1425 nSadison Everett — <br />ARGHiTECT OR �ESIGNER MAIL ADDRE55 <br />CITY LIP PMONE <br />MAIL ADD`1ESS <br />GITY ZIP FHONE UCENSE 1 <br />GENERALCONTRACTOR <br />S�e ��ry ZIP PHONE UCENSE I <br />MEGNFNiGALLONiRACiOR MA:LADOPE55 <br />-- CITY ZIP PHONE LICENSE Y <br />PLUMBING CONTRFCTOR MAIL AD�RESS <br />SS CF WORK <br />❑NEW �DDITION ❑ALTERATION ❑REPA�q ❑DEMOLITION ❑FENCE ❑SIGN GARAGE <br />.UATION OF WORK <br />y 2SOO.00 <br />����Add 11'xl2' Addition to Existing Residence <br />aaornsEo use oF ouaowc <br />single family residence _ <br />LEGAL DESCRIPTION OF PROPF.RTV ISMOW BELOW OR ATTACN FOUR CAPIE57 <br />11-12 3 Beverly Park <br />LOT 6LOCK_OF <br />1425 Madison <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />0 <br />� <br />YARD SETBACK <br />5' <br />i1ZE CF BLDG. <br />11'12' add. <br />� <br />STRLETSETBAGK <br />20' <br />LOT AREA <br />OCCUPANCY GRO <br />R-3 <br />NO. OF STORIES <br />1 <br />BASEMENT <br />none <br />1. ENVIRONMENTALCHECKLIST <br />2. BUILDING FLANS <br />3. FIRE HVDRANT <br />4, FIRE PROTECTION SYSTEM <br />5. GF7ADING <br />6. DRAINAGE <br />Z ENVIflONNEHTAL IMPACT STATEMENT <br />�. HEALTH DISTRICT _ <br />APPLICATION ACC. 9Y . PLANS CHECYED BY <br />V.C. <br />20' <br />VACANT SITE <br />❑YES i}j,� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATiON AND KNOW THE SAME TO BE TRUr AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCFS GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHFTHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />?RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTI N�R-7H�.PcRFORMANCE OF CONSTRUCTION. <br />SIG T�/ F L NTRAGT /}1��1RIZE0 AGENt <br />i /+ �! �/ 6/24/80 <br />APPR.FORISSUANCE BV <br />). UNITS — H,P. EA. <br />' 4TION UNITS — H.P. EA <br />— H P. EA. <br />D A.C. UNITS —TONNAGE EA_ <br />AIR SYSiEMS — ��T��� M <br />AiENS — B T.U. � <br />�TFRS — d.T.U. M <br />80/7804 <br />FEI <br />BUILDING <br />PLI.'MBING <br />MECHANICAL <br />GTNER <br />FEE 12,�0 <br />s 25��.�� <br />U.BA. <br />SEC. 303 (a) <br />RECF.IPT HO. <br />� �� <br />PENMII VPuuHuv�. <br />WHEN PROPERLY VALIDATED (�N THIS SPPCE) THI515 YOUR PERidIT <br />3y30 $024.00 - �� <br />� <br />r- <br />• 1'�UR RECEIPT� <br />� ; ,�,�n : Yo u <br />2 j ,r.R'� 8 � <br />ADDRESS FlLE . <br />