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rdeEvergreen —� C� NSTRUCTI�N � - <br />",Y�� pEFiMIT <br />everett PERMIT NO.OH229 <br />CITY HALL 259-8745 <br />evearrr wn eezui ❑ COMBINATION 7�X BUILDING ❑ MECHANICAL PLUMBiNG <br />cirr ziv vnor+r <br />ONNER MAIL AUDRE55 2 5 9- 4 2 3 2 <br />Mary Jamieson 2229 Hoyt 9E',201 <br />nRCNRECi OR DESiGNER IAAR /DDRE55 <br />CITY ZIP PHONE <br />�... GNON[ IICENSE I <br />Same <br />MECNANICPL CANiRACTOR N411 ADDRESS <br />cin zia rHor+E ucErvse r <br />C�rY Z�p PHONE !ICENSE � <br />FLUMBING CONiRACTOR MAiL AD�RESS <br />❑NEW <br />f 300.00 <br />❑ADDITION ❑ALTERATION }GP.REPAIR ❑DEMOIITION ❑FENGE ❑SIGN ❑GARAGE <br />single family residence <br />21-22 481 Everett <br />lOi BLOCN__OF — <br />J0� PDDPE55 <br />2224 Noyt <br />PLUMBING <br />un � TYPE OF PIXTURE OR ITEM _ <br />0 <br />� <br />VARD SETBACK � STRFET SETI3ACK <br />USE ZONE I LOT AfiEA <br />N0 <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUIIDINGPIANS <br />3. FIRE HYDfiANT _ <br />4. FIRE PROTECTION SVSTEM <br />5 GRADWG <br />6. DRAINAGE <br />7. ENVIRONMENTALIMPACT STATEMENT <br />8. HEALTH OISTRICT <br />APPUCATION ACC B� PlANS CHECKED BV <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 PRO`JISIONS OF LAWS AND ORDINANCES GOVERMING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTWG OF A PERMIT DOES IdOT <br />PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCFL LAW REGULATING <br />CONSTRUCTION OR HE PERFORMANCE OF CONSTR�UCTION. <br />SGI�,�i.U� Of CONLFnC10A pAU�NORiZE[)FGENt � <br />���� i,t� , ea��--�v Q-�-'Ci g/8/8� <br />FEE <br />OEAR VARD <br />vFCANi SITE <br />C1YES L]NO <br />NO.OF DWELLING UNITS <br />APPR. FOR �SSUANCE 0�' <br />wnu <br />�i� <br />PLUMBING <br />MECHANICAI <br />E OF EOUIPMF. <br />—HF EA <br />UNIiS — HP. EA <br />unn o — <br />$TE!.15—BT.I� M <br />—BT.0 M <br />_nru �+ <br />s <br />FEE <br />$ 300. <br />PECEIPT N0. <br />� �� <br />PENALTY U 8 C. <br />SEC. 303 (a) <br />TOTA� 5 00 <br />PERMIT VALIOATION <br />WHEN PROPEFiLY VALIf]AIED (IN THIS SPACE) THIS IS YOUR PERMIT <br />7445 �005.��---- � <br />N <br />� <br />�� � �.) � �;ECEIPT � <br />���: �,ou <br />