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, �,,�.�,�.,A,��-,� �ONSTF'�UCTI� <br />_�r� �. �� <br />1�1����� PERMI�' PERMIT NO. =-� <br />CITY HALL 159�87<5 <br />,; r�eaei�;}vi�9azoi x� COfNBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />0\'lf�EP <br />MNIL AD�RE55 CRY ZIP V.IONE --` <br />S. A. HAGER 801 HOYT ��pi�qooREEVERETT 4!A �iry Zip PHor+E <br />FNGnITEGT OR DESIGNEF <br />GE��ERALGONTRAGtOR <br />MAIL ADORE55 CITY ZIP PNONE L'Ci � � <br />MEL F�RREV 7532 LOWER RIDGE ROAD EVERETT 353-4659 — <br />..... ......,.« CITY ZIP PMONE LIC['� '� <br />❑ NEW � <br />VALUATIJN OF WORN <br />S 30f���.�� <br />�ESCRIBE YIORN <br />Addn - family <br />P(i0PO5E� USE OF fViL�ING <br />Residence <br />� W FL �E�GRIPTION OF PROFEf <br />�o-�'� e�ocK 168oF <br />aoe nooness <br />801 Hoyt. <br />PLUMBING <br />NO. 7YPE OF <br />BATHTUB <br />CC�1 <br />ADDIT�ON ❑ ALTERATION ❑ REPAIR O DEMOLITICN ❑ FENCE ❑ SIGN 0 WOOD STOVFJFIREPLACE 11::;f--� <br />bath <br />Grandview Addn <br />OR <br />� SHOWER <br />KITCHEN SINK 8 DISP. <br />�ISHWASFER <br />LAUNORYTRAY <br />� CLOTHES WASHER <br />WATER HEATER <br />11RINAL _ <br />DRINKING FOUNTAIN <br />FLOOFi DRAIN <br />VACUUM BREAKERS <br />RCOF DRAINS — RA�NLEADERS <br />SiNK iSERVICE — BAR, ETC 1 <br />TYPE OF CON <br />V-N <br />SIZE OF B�DC <br />410 sf <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />R-3 <br />� <br />t [NVIRONtdLNTAL CHECK LIST <br />2. �UILOING PLANS <br />3. FIRE HVDRANT <br />a PIREPROTECTIONSVSTEM <br />S.GPA�ING � <br />fi. DRAINAGE <br />1.ENV:RONMENTALIMPACTS7A' <br />U. HEALTH DISTRICT �_ <br />,APPLICATION ACC� BY �_P}P <br />stg _ �hwm <br />; <br />� <br />S <br />5 <br />REAR VARD S <br />VACANT SITF <br />�..YES _�NO <br />NO. OF DWEL <br />� <br />MA%. OCG L( <br />FOR <br />lc <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TP;I� <br />APPLICATION AND KNOW THE SAME TO BE TRUE AF:D <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANC:->� <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED :�'il-;-: <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Oi- %. <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOL�-� � E. <br />OF CANCEL THE PROVISIONS OF ANY OTHER STATE �>�+ <br />LOCAL LAW REGUTATING CONSTRUCTION OR -iN:= <br />PERFORMNNCE OF CONSTRUCfION. q E � <br />SIGNAi45E OF GONT ACTOR OR AU RIZED AGENI <br />� ``� ' -� s-�, �, <br />� <br />MECHANICAL _ <br />NO. TYPE OF EOUIPMENT � FEE <br />AIR C7ND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. _ <br />BOILEFS — F..P. EA. <br />GAS FIRED A.G UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. �� <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS __ <br />� VENTILATION fAN 3 OO <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — N�000 <br />� METAL PIREPLACE & CHIMNEY <br />� FIREPLACEINSEFT <br />HEAT PUMP <br />SUBTOTAL f <br />PENMI7 S <br />TOTAL FEE s <br />C4ECK NUmtltn ' `^" """' - -- <br />84/13847 FEE 125.45 I �� S�CEIPT NO. <br />vooc VALUATION FEE <br />BUILDING g30,000. _ 193 00 <br />PLUMBING B OO_ <br />MECHANICAL 3 OO <br />OTHER <br />U.B.C. <br />PENALTY SEC.3031a) <br />TOTA� 204 00 <br />PEflM1T VALIDATION <br />WMEN PROPERLY VA!.IDATED (IN TNIS SPACE) THIS �5 �O�U9,PEAMIT_ � <br />i 5 � �� <br />� <br />M <br />. i � � l � <br />BY <br />_ I�l �� <br />ADDRESS FIL[ <br />- r _ ° i, �i <br />