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fhsEvergreen .��PPLICATI�JN FOR <br />anoF . �ONSTR�JC�10� . everetl <br />�verett pE�Miy e <br />DEPT. OF COMMUNITY DE\'ELOPMENT SERVICES <br />CITY HALL 259�8745 <br />EVERCTT, WA98201 �COM.BINATION ❑ BUILDING ❑MECtiANICAL ❑PLUMBING PERMIT NO. <br />O\VNI : MeR eDJX[55 [IT1 <br />//r�y. �f �( ZIP �IIONE <br />Liil�>L� �'1 �/ VLN .J ll�S /�'J/ii-I)SON E�/eiYr,/f <br />R <br />ZIP <br />G[rvFRnICJNi0.eR00. h1AllA00PF55 Cliv 21a PNON[ �i[ENSi� <br />.s�.4"/f' yc�rr• �--Z�jDYot.r�lrn.Y s�.�i�/ z-sr �v, -��'� 353- 9275' /.�/cd r+�h' �!2 /7 C. <br />MfCHnNUI CpYiP�CtOR / MAII ADORF55 CITY 21P PHOM[ IICENSf 1 <br />1'lUMffl�:�:CONIR�CLOR M1IAILAO�R[S$ CIIY 21V PHONE LICENSEI <br />Cl�>5 Of NC.3N � <br />�SINEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑fENCE ❑SIGN ❑GARAGE ❑HUILDINI; RELOCAT:ON <br />V�II,IAIION Of \YORK <br />S ( 6f�n^� <br />TTV V! <br />DlSlN101 N�OXA <br />1'NOPOSI U USF Of <br />�`�W/� �ii <br />LEGAI Uf SCRIPt10N Oi PROPERLY ISMONN IIFION' OR AiT�GI lOUR COPI[S) <br />io���eioapy��°or %�rvrrly N/Ll.� , <br />2i]ml�iii <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />IiA1HTU❑ <br />UVATORY �\YA$ <br />SHOwER <br />KITCHEN SINK 8 <br />OIS\vASMfR <br />CLOiHESVVASHER <br />UHINAI <br />DftINKINC fOUNTAIN <br />fLOOR []HAIN <br />VANUM OREAKEftS <br />HOO�DRAINS-RAINIEADERS <br />9NK 6FRVICL-HAH, ETC � <br />SUB TOTAL <br />SIDF VAftD SETI7ACK STRfET SCTpACK <br />� p- 20 <br />USE ZOtiL LOT ANEA <br />. �--' � ( ��� �� <br />TY9[ Of NuSi OCCUPnNCYGFOUP <br />� n� r�t <br />517.f OF I1L0:; NO OF STOHIES <br />6� 5• � I <br />HHFZONE �ASEMENT N�pNU( <br />APPROVAlS <br />i ENVIRONM(NiAL CHECK LIST <br />2 BUILDINC VLANS <br />7 fINE MYONANi <br />4 FIHE PP.OTE�710�� SYSTEM <br />5 GNADINC�1%U\'ATIONdCIfARINGICRUHdINL <br />6 DNAINnCF <br />7. ENVIRONMENUL Ih1PACT S7ATEMENT <br />B NFALTII DISTHICT <br />APPLIUTION ACC BY PLANS CHEIXED OV <br />�i <br />��-. ai tr�_t�, ), <br />91-;9 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO PE TRUE A":D CORRECT ALL <br />PROV�SIONS OF LAWS AND ORDINANCES CGVERNING THIS TYPE <br />OF WORK WILL UE COMPL�EU WITH'NHETIIER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOC�L LAW REGULATING CONSTRU�TION <br />OR TIIE PERFORMANCE OF CONSTRUCTION. <br />SIGN,\TURE OF CONTHACTOR ON AUTHORIZED AGENT DATE <br />� c <br />Y �7� � %L �..� �( / % '� � L % �O-�, <br />MECHANICAL � <br />FEE N.O. TYPE OF EQUIPMENT FEE <br />AIH CCtaU UhRS-H P EA <br />REfR:GI'tAiION VM1I75-H P. EA <br />BOLLCPS-HV kA <br />GAS YINCD I, C UNIiS-TONNAGk EA <br />IORCfD AIH $VSTEM$-O T U M EA <br />WAILM:..�[RS-OTU. M <br />UNIiHkATfRS-13TU. M <br />k\'APORAiIVE COOLEftS <br />�S <br />NCAR YARD 5[TpI.CK <br />Z� -r- -r <br />V�.MNI :ITk <br />IlYCS 5�74�0 <br />BY � DATE <br />APPR fOR ISSUANCE HY <br />� • L . <br />\'[Ni1U7104 fAN <br />RANGEMOOD <br />AIN IIAKOIING UNIT- C F M <br />STOVE <br />METAL FlHEPUCI. 8 CHIMNEY <br />SUB TOTAI S <br />PENMIT S <br />PIAN CM(CK NUM�CR VLAI. _ IECK FEE <br />�("�� ftE .� g RECEIP7 NO. <br />l /�ScC 3, � ' <br />fF�S VALUATION fEE <br />����o��� 'G��X''D_fr' ;5 <br />YWMBING <br />MECH�NIGL <br />OTHER <br />PENALTY V.N C. <br />SEC 301(al <br />TOTAI i 7 �'j <br />�Jl1 �7� <br />PERMIT VAIIUATION <br />1VMEN YHOPERLY VALIUATED (IN THIS SPACEI THIS IS YOUR PERMIT <br />L�lJL, /�L.b.tJ L ��C�ICG- �2 /�c/t- <br />�,�j��%�%. <br />t <br />-J <br />