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theEvergreen � C�STRUCTION <br />i^-�, <br />CITY OF . � . . � �, <br />everett PERMIT pERMIT NO.OS1O7 I <br />CITV HALL 259�8745 i <br />EVERETT, WA 98201 ❑ COMBINATION �c BUILDINO ❑ MECHANICAL ❑ PLUM81N0 <br />OWNER !•AIL�DDRE55 CITY ZIP PMONE , <br />Q <br />Tony Martin 9621 4th Street S.E. 98205 334-192 <br />ARCHITECT OH DE5IGNER MAIL ADDRE55 CITY ZIP PHONE . <br />i <br />GENEML CONTMCTON MAIL AODPESS CITY ZIF PMONE LICENSE � <br />Same <br />MECHANIGLCONTiIACTOR MMLADDPESS CITY ZIP PHONE LICENSE� � <br />PLUMBINOCONfMCTOR MAIL�DDRE55 CITV ZIP %10NE LILENSE/ <br />GUSi t� rYum <br />❑NEW ❑ADDITION ❑ALTtRATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GAMGE <br />VALU�TION OF WORK <br />f 501���.a� <br />DE9CN�BE M/0111( <br />ralocete houee from 3732 Sf2Y]t <br />NqP06ED USE OF BUILDINO <br />sinqle family reeidence <br />lE((SILL pESprypfqN pF qqPEpfY �SNOW BELOW ON ATfACH FOUR COflESI <br />�0�8-29 �� 5 oF Smyth Land Co's 2 <br />3917 81gh Straet <br />K�1� <br />, � <br />V SIDE VARD SETB�CN <br />� 6' <br />� <br />U6E ZONE <br />R-1 <br />' TVPE OF CONST. <br />V-N <br />S12E OF BLD6. <br />30'X48' <br />FIRE 20NE 3 <br />STREETSETBAGK <br />20' <br />LOT AREA <br />OCCUPANCY GROU <br />R-3 <br />N0. OF STOFlIES <br />1 <br />BASEMENT <br />none <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDINQ PUNS <br />3. FIRE HYDRANT <br />1. FIRE PROTECTION SYST9d <br />5. GRADYlG '- <br />8. DRAMIR'aE �i.• A <br />-, <br />7. ENVII�IMENTALaP�STP <br />T) t <br />B. HEALIH DI5TRICT f7� <br />ACC. BYi <br />l <br />r:-_ <br />V <br />m <br />Colby to 3917 Hiqh Street <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />nd ALl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE CAMPLIED WITH �VHEfHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO• <br />VISIONS OF ANY OTHER sTATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PENFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AL'7HORIZED AGENT DATE <br />X �.,,�. �li.�. 9'/�/rs• <br />2�� <br />si� <br />❑NO <br />DWELI <br />1 <br />iATION UNITS — H.P. EA <br />— H.P. EA. <br />D A.C. UNITS — TONNAGE EA. <br />AIR SYSTEMS — B.T.U. M <br />ATERS — B.T.U. M <br />�rcac—a7u M <br />& <br />80/8107 <br />UNITS <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />FEE g3.5 <br />s50,000. <br />U.B.C. <br />SEC.303(a) <br />REGEIPf NO. <br />{9888 � <br />FEE <br />187 00 ' <br />12 00 <br />3 00 <br />202 00; <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS yOi R PEqMO O-`-" � <br />7186 E 8� <br />0 <br />�►rt � 2. 0 �—� 00 <br />1'OUR RECEIPT � <br />C�NEDBY APPR'FOR���+�R R�CEIpr � 1�HANK YOU <br />VIC. ' . , . .� <br />