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r <br />d�c Erer�;recn <br />��T� QF <br />everett <br />CITY HALL 259�B7a5 <br />� -�ONSTRUCTIO�' <br />PERMIT PeRnnirNo. 13993 <br />EVERETT,WA98207 � LpMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER Ml+ILAD�FE55 CITY ZIP PMONE <br />FRE� & MARY BRADLEY 1929 HICHLAN� EVEREYT WA 98201 252-��+54 <br />RRGNRECT OR DESIGNEF MAIL n�DRESS CITY 21P PHONE <br />GENERAL CONTRACTOR MAIL A��RESS GTY ZIP PMONE LICENSE P <br />MATCHETT"S ROOFIN G 8328 - 47th NE Marysville WA 98270 659-7877 MATCHR165C72Z,'�-02 <br />MECHANICAL GONTRACTOR MAIL AOORESS GTY ZIP PHONE LICENSE N <br />PLUMBING CONTPFLTOR MAIL AOOPE55 CITV ZIP PMONE LICENSE � <br />❑ NEW ❑ ADDITION ❑ ALTERATION YyO REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WO00 STOVFJFIREPLACE INSERT <br />VALUATION OP WOFR <br />f.3f0�0.00 <br />DESLflIBE WORK <br />�OT <br />JOB AD�RESS <br />PLUMBINO <br />NO. T' <br />WATER CI <br />BA7HTUB <br />LAVATOR <br />SHOWER <br />KITCHEN <br />SIZE <br />OF FIXTURE OR ITEM <br />6N�iN) <br />LAUNORYTRAV <br />CLOTHES WASHER <br />WATEH HEATER <br />UPINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VAGUUM BREAKERS <br />ROOF ORAINS — RAINLEADE <br />SINK (SERVICE — BAR. ETQ) <br />TOTAI <br />TOTAL <br />APPqOVRLS <br />1. ENVIRONMENTAL CHECK LIST <br />:. BUILDING PLANS <br />3. �'RE HYDRANT <br />a. FIf;E ^ROTECTIOI� SYSTEM <br />5. GPADING <br />fi.DHAINAGE <br />7.ENVIR�;�MEN7ALIMPACTSTATEMEN7 <br />i,. H:ALTH DISTRICT <br />AF?LICATIOII ACC. BY PLANS CHE <br />f <br />FEE <br />� <br />f <br />S <br />REAR YARD S <br />VACANT SITE <br />..YES .�.NO <br />NO. OF DWEL <br />MAX. OCC. L( <br />APPR.FOR <br />I HEREBY CERTIFY THAT I HAVE FEAD A�D EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUP�y GONTRACTOR O AUTHONRED AGENT OATE <br />X �i'Gii.�,si _ ' U�� �84 <br />�,s <br />NO. TYPE OF EQUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNI7S — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNIiS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEA7EP5 — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN _ <br />RANGEHOOD <br />AIR HAN�LING UNI7 — C.F.M. <br />STOVE — WOOD <br />ME7AL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSER7 <br />HEAT PUMP <br />SUB TOTAL i <br />PERMIT S <br />TOTAL fEE S <br />ETBACK PLAN CHECK NUMBER PLAN C <br />FEE <br />FEES VALUATION <br />LING UNITS <br />BUILDING $3�000. <br />iAD -- <br />PLUMBING <br />.ERS MECHANICAL <br />DATE OTHER <br />U.9.C. <br />PENAL7V ccc am �a� <br />FEE <br />RECEIPT NO. <br />FEE <br />38 <br />TOTAL " <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED QN THIS SIPACE� TMIS iS,Y�J F�PF�PMIT_ M <br />Z � -c*i <br />m <br />M <br />!;:�� <br />BY <br />l�L�CRCF�`_ i-1L`_ <br />- I : , <br />z <br />0 <br />-� <br />n-� <br />� <br />m <br />.. ... <br />1 T <br />�--� —1 <br />N 2 <br />0 <br />m <br />co <br />m �o,� <br />-i c <br />O 3 <br />--1 2 <br />S --1 <br />n� <br />.02 <br />D --I <br />r s <br />... .. <br />--� N <br />L <br />T <br />O A <br />T D <br />3 <br />�m <br />2 <br />m � <br />N <br />o r <br />c� m <br />C N <br />3 N <br />m <br />z c� <br />�r <br />. m <br />a <br />� <br />-a <br />x <br />n <br />z <br />� <br />S <br />� <br />Z <br />O <br />--I <br />�-. <br />n <br />m <br />� <br />