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the Evergreen <br />O N ST RU OT I O N <br />CITY OF <br />everett <br />PERMIT <br />PERMIT NO. <br />085315 <br />CITY HALL 9a745 <br />NATION ❑ BUILDING El MECHANICAL <br />❑ COMBINATION X <br />El PLUMBING <br />01 <br />EVERETT, WAA 98201 <br />OWNER MAIL ADDRESS CITY <br />Pack 710 Wall Street Everett <br />ZIP PHONE <br />98201 259-5573 <br />James D. <br />CITY <br />'.P <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ApLflE55 <br />MAIL AODPESS CITY <br />ZIP <br />PHONE LICENSE <br />GENERAL CONTRACTOR <br />Same <br />CITY <br />ZIP <br />PHONE LICENSE IF <br />MECHANICAL CONTRACTOR <br />MAIL ADDREBB <br />MAIL ADDRESS CITY <br />ZIP <br />PHON LICENSE <br />PILL MRING CONTRACTOR <br />CLASS OF WORK <br />❑NEW ❑ADDITION ALTERATION ❑REPAIR ❑DEMOLITION []FENCE ❑SIGN EIGARAGE <br />VALUATION OF WORK <br />S 7,000.00 <br />DESCRIBE WORK <br />Conv3rt Single Family Residence to Duplex <br />PROPOSED USE OF BUILDING <br />I HERBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />Duplex <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BE LOW ORATTACH FOURCOPIES) PLICATION AND KNOW THE SAME TO BF=TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />E0 RLocK 24 OF Town of Lo e TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />PRESUMHEREIN OOGIVEAUTHORITYTOVIO F EO CANCDORMITHEPROT <br />VISIONS OF ANY OTHER STFA OR OC LAW REGULATING <br />CON,IUCTION OR THE PER O M C F CONSTRUCTION. <br />u nlRc FrnNTRACTOfl OR AUTII E A DATE <br />2116 Main Street <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />EXISTING <br />STRUCTURE <br />USE ZONE <br />R-2 <br />LOT AREA <br />7200 Sq. F <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />V-N <br />R-3 <br />SIZE OF BLDG, <br />NO. OF STORIES <br />2 <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />r. <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />5. GRADING <br />& DRAINAGE <br />]. ENVIRONMENTAL IMPACLraTP <br />CAPPLICATION ACC) BY i� NS CHECKED BY <br />C <br />_ I V.C. <br />(� 'i7 <br />I <br />ECH GICALNO. TYPE OF EQUIPMENTAIR COND. UNITS — H.P. EA.REFRIGERATION UNITS— H.P. EABOILERS—H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />2 CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — C <br />TEAR YARD SETBACK PLAN CHECK NUMUt <br />BO/8535 <br />VACANT SITE FEE <br />OYES X1X0 <br />2 (BUILDING <br />PENALTY <br />rEE 40.63 <br />S 7,000 <br />U.B.C. <br />SEC. 303 <br />510114 D <br />FEE <br />PERMIT VALIYAII-- <br />y{E,�I (�U <br />II WRAPEOLx VALIDATE�N THIS SPACE) THIS IS YOUR PERMIT <br />�(J `b I 62 5 O --ub <br />M <br />In <br />r. tccciPi �:cFiri <br />APPR. FOR ISSUANCE BYE �{ �' U <br />