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rdr Err.Areen <br />uTv G: <br />everett <br />CITV HALL 259�8745 <br />'- �ONSTRULTION <br />PERM IT PERMIT NO. �-4� 3� <br />EVERETT,WA98201 ❑ COMBINATION X� BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL AODRESS CITV 21P PMONE <br />PHIL FOWBERT SR 3902 HIGH STREET EVFRFTT wA �aa_�1�o <br />APGHITECT OR DESIGNER MAIL ADDRESS CITV 21P PMONE <br />GENERAL CONTFACTOR MAI� ADDRESS CITY ZIP PHONE LICENSE � <br />NORTHSOUND BLDRS 9208 SMOKEY PT B�vo Qaa�n F53_��i� NORTHB��8Ja <br />MECHRNICPL CONTRACTOR MAIL ADDRE55 CITY ZIP PHONE LICENSE 1r <br />PLUMBING WNTHACTOR MAIL A��PES$ GITY pIP PNONE UCENSE Y <br />❑ NEW O ADDITION � ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />f 4��0�.�� <br />DESCFIBE WORk <br />Reside residence <br />Residence <br />LEGAL OESCRIPTION OF PROPERTY �. <br />l0T 52&�OCK 00�F_ <br />5788 002 052 000 <br />J06 AOOPE55 <br />3902 High Street <br />PLUMBINfi <br />NO. TYPE OP FIXTI <br />WA7ER CLOSET(701LET) <br />BATHTUB <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />OW BE�OW OR ATfAGH FOUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />SMITH LAND CO 2nd Addn GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />SHOWER <br />KITCNEN SINK 8 DISP. <br />DISHWASHER <br />LAUN�RVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF �RAINS - RAINLEA�ERS <br />SINK (SEHVICE - BAR, E7C.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />APPROVALS <br />t. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE MYDRANT <br />4. FIRE Fr70TECTION SYS7EM <br />5. GRADING <br />6. �RAINAGE <br />7.ENVIRONMENTALIMPAfTSTATEMEN"i <br />8. HEAL7H OISTRIC7 <br />APPLICATION ACC. BV PLANS CHECY�'� BV <br />AGENT DRTE <br />FEE /NO TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNI7S — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />W/�LL HEATERS — B.T.U. M <br />U�IT HEATERS — B.T.U. M <br />� EV4PORATIVECOOLERS <br />. CIOTHES �RYERS <br />1 <br />REAR Y4RD SETBACK PLAN <br />.:YES �,:NO <br />BY I DA7E <br />A��� 9. FOR ISSl1ANCE BY <br />RANGEHOOD <br />AIR HANULING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE:NSERT <br />HEAT PUMP <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />FEE I RECEIPT NO. <br />VALUATION I FEE <br />BUILDING � 5 4000,00 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTV U.B.C. <br />SEC. 903 (a) <br />TOTAL I I �� I''� <br />PERMIT VALIDATION <br />WMEN PROPERLV VALIDATED �IN 7HIS SPACE) THIS IS YOUR PERMIT � <br />( r I, ;.!', I' C� _ r�A <br />•�r <br />i'-� <br />�' <br />,, -,-.. ��,_; r-i <br />,J <br />ADDP.ESS FII[ <br />z <br />0 <br />� <br />c� <br />m <br />FV M <br />� T <br />.. -i <br />N S <br />c <br />m <br />co <br />m o <br />fY <br />--1 C <br />03 <br />—I 2 <br />S —1 <br />m <br />.. <br />C z <br />r 2 <br />—i N <br />< <br />O A <br />T 9 <br />-i m <br />m� <br />N <br />J <br />om <br />C N <br />� N <br />2 C� <br />�m <br />a <br />� <br />-a <br />x <br />a <br />2 <br />--i <br />2 <br />N <br />2 <br />O <br />-�-I <br />� <br />n <br />m <br />� <br />