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the Evergreen <br />GTY OF <br />everett <br />CITY HAI L 259�8745 <br />� �ONSTRUCTIOIy� <br />PERMlT <br />• <br />PERMIT NO: 069i)9 <br />EVERETT,WA 98201 ❑ COMBINATION I�BUILDIN(i ❑ MECHANICAL ❑ PLUMBINa <br />OWNER MRILAOOPE55 GIiY ZIP VNONE <br />John Campbell P.O. Box 5657 Everett 98206 353-5962 <br />ANCHRECT OR DESIGNER MRIL ApOFE55 CITY ZI? PHONE <br />GFNERA� fANTPACiOR AIRIL ADOPE55 dTY ZIP PHONE LICENSE I <br />H. 6 H. Conatruction 8421 12th Street S.E. Eyerett 98205 334-3632 <br />MECHANICFLIXJNiBlLTOR MAILApPPE55 �ITY ZIP PHONE IICENSE� <br />PIUMBINGCONTRAGiOR MRILA�DRE55 CITY ZIP PHONE UCENEE� <br />CLASS OF WOPK <br />❑NEW ❑ADDITION }(}�ALTERA710N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VPLUATION OF WORN <br />} 20�0.0� <br />Concrete footings <br />��oaoseo use or eunoiHc <br />Single family residence <br />�or 3 �eioc�or <br />BEL01Y OR ATTACH POUR fAPIESI <br />St. Nicholas <br />Vo^1829 Highland Avenue <br />PLUMBING <br />N0. TYPE OF flXl UR <br />IVATER CLOSET �TOILET) <br />BATHTUO <br />i/1VAlORV (YJASH �ASIN) <br />SHOWER <br />KITCNEN SINK 8 OISP. <br />DISHWASHER <br />LAUNDRV 1RAY <br />CLOTHES WASHER <br />WATER HEATEfl <br />URINAL <br />l RINKING FOl1NTAIN <br />fLOOR DRAIN <br />VACUUh1�REAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BA0. ETC 1 <br />SIDE VARD SETBACH STR[[T SET�. <br />USE ZONE LOT AREA <br />TYPE OF WNST. OCCUPANC` <br />SIZE OF BLDG. NO. OF S70 <br />FIRE ZON� BASEMENT <br />APPROVALS <br />1. BNVIFONMENiAL CHECK LIST <br />2 BUIl.DING PLANS <br />9. FIRE HYURANT <br />a. FIRE PROTECTION SYS7EM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMLNT <br />B. HEALTH DISTRIGT <br />APPLICATION ACC. BV I PLANS CHECKED BY <br />REAR VARD SETBACK <br />VACANT SITE <br />'.1VES I1N0 <br />N0. OF DWELLING UNITS <br />MAX.00C.LOAD <br />FIRE SPRINKLERS <br />PEOUIRED <br />❑�ES !lN0 <br />BY .� OATE <br />APPR.FORISSUANCEBY <br />I HEREEY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLI�ATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GFANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO• <br />VISIONS OF ANY OTHER STATE OR LOCA� LAW REGULATING <br />CONSTRU�^TION OR/�HE PERFORMANCE OF, CONST1iNCTION. <br />X <br />2E�YA(1ENi OALE <br />. _ . / : �1/5/79 <br />AIR COND UNITS -- H.P. EA. <br />REFRIGERATION 1/N1T5 — H. <br />�OIL[RS — H P. EA. <br />(;AS FIREO A C. UNRS — TO! <br />YJALL HEATERS —`�1T.U. <br />UNIT HEATERS — B.T.U. <br />[VAPORATNE COOLE(iS <br />VENTILATION PAN <br />AIR HANDLING UNIT — <br />M <br />GF,M <br />METAL PIREPLACE & CMIMNEV <br />FEE <br />s 2,000.00 <br />U.B C. <br />SEC. 3091a) <br />RECEIP7 NO. <br />PROPERLY VALIDATED QN iMIS S:A`E`T`IS IS YQ`I� �F�11� �,� � <br />1711 +U V <br />. i � 0 <br />Yd'U�R REG�ElPT� <br />TyANK YpfiJ � <br />, ; ♦ i � it '.� <br />_ � t�ai .79. <br />