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U�e Evergreen �p N ST R U CT I O N � <br />GTY OF <br />everett PERMIT pERh11T NO. 1116'4 <br />CiTV HA�L'r.o9�87d5 <br />ev�aen, vaa �ozoi ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OYMER MAIL ADOPLSS CITY ZIP P110N[ <br />LELAND L. ARTIIAUD 1802 b1ADISON ST EVERETT 98203 353-2285 <br />APCHiiECt OR �ESiGNEfi MAIL ADDPE55 GTY LP PHONE <br />GEN[RaLCONTRRGTOR MA4qDDPESS CITY ZIP PHONE LICENSE� <br />AIECIIANICALCONTRACTOR MAILAOOPESS CItY ZIP PHONE LICENSE� <br />Owner <br />PWM�INGWNiRACTOP IAAILFDDR[55 CITY ZIP PMONE LICENSE� <br />�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMULITION ❑FENCE ❑SIGN ❑GARAGE <br />5 <br />�ESCRipE WOFK <br />FIR� PLACE INSERT <br />PRO�'OSE� US:OF pUIL01NG <br />RfiSID�NCE <br />LEGhL DESCRIPiION OF PROPERTY �SNOV/ �El <br />�or eiocK_cr <br />�ou �uuacss — <br />1802 Madison <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITE�N <br />W�TER CLOSET <br />9A7HTU0 <br />LAVATORV (WAS <br />SHOWER <br />KITCHEN SINK A <br />DISHWASHER <br />LAUNORYTRAY <br />CLOTHES WASH <br />WATER HEATER <br />URINAL <br />DRINKING fOUI <br />FLOOR DRAIN <br />ROOF <br />SIDE YARD SETBACK <br />— BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />STREET SETBACK <br />LOT AREA <br />OCCUPANCV GR( <br />N0. OF S70PIES <br />REAR YARD <br />VACANT SITE <br />L7VE5 I_iN0 <br />NO. OF DWELLING UNITS <br />OCC.LOAD <br />SPRINKLERS <br />APf'ROVALS BY DA7E <br />L ENVIRONIdENTAL CHECK LIST <br />2. BUILDMGPLANS _ <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DfiAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8. HEAITH DISTRICT <br />APPUCATIUN ACQ GY PLANS CHECKED BY APPR. FOR ISSUANCE BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EX.AMINED THIS AP- <br />PUCATION AND KNOW THE SAME TO BE T�UE AND CORFECT. <br />ALL PROVISIONj OF LAWS AND ORDINANCES aOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THC GRANTING OF A PE�MIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTR CTION R T E P RFORMANCE OF CONSTRUCTION. <br />si�Nnru�a ''F,or+ra roe nun �mze ;e�r onrc <br />X /i�e� � /1 1 10/20/82 <br />NO. � TYPE C <br />AIR COND. UNITS — <br />REFRIGERATION UNITS — HP. EA <br />�OILERS — H.P.EA. <br />GAS FlFED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. �d <br />bVALLHEATEFS—BT.U. �.� <br />11N1T HEATERS — B.T.LL �d <br />CLOTHES �RYERS <br />VENiILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — CF.M. <br />STOVE <br />METAL RREPLACE 8 CHIMNEY <br />� TOTALFE£ <br />'LAN CHECK NUMBER <br />FEE <br />fEES VAL <br />BUILDING 5 <br />PWMBING <br />AIECHANICAL <br />CHECKFE[ <br />RECEIPT NO <br />� <br />PENALTY U 8 C. <br />SEC.303(a1 <br />TOTAL <br />PERMIT VALIDATION <br />IVHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PE47MIT <br />� <br />9103 $0�1.50-�1 <br />t"'i <br />[-i <br />Y;�UR RECtIPT <br />TNANK YOU <br />?.��r�^��.,-,i r_ � � �nj 0? <br />i� <br />� <br />_� <br />