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� the Evergreen <br />�iT� �F <br />everett <br />CITY HALL 25&B7d5 <br />EVERETT, WA 98207 <br />� rCONSTRUCTlO� � <br />PERMIT PERMIT N0. 14916 <br />❑ COMBINATION ❑ BUILDIN(3 C� MECHANICAL ❑ PLUMBING <br />OWNEN MAIL �DDRE55 <br />M, L. GREGG 2215 }tI(��.AND AVII�UE EVERETT WA 98201 252-1339 <br />ARCHITECT OR DESIGNER M�IL ADDRESS � 1T' ZIP PMONE <br />6ENERAL CONTR�CTOR M�IL �DDRESS CIiY 21P PHONE LICENBE � <br />Same <br />MECHANICALGONTRACTOR <br />MAILADDRE55 CITV 21P PNONE LILENlE1 <br />PLUMBING CONTR�CTOR <br />MAIL FDDRE55 CITY ZIP PNONE LIGENSE 1 <br />ClASS OF WONN <br />❑ ryEyV Q AUDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN Y� N�OOD STOVEIFIREPUCE IN <br />VALUATION OF WORK <br />f <br />escn�B715L811 WOOd $tOV@ <br />1 <br />ROPO ED US OF BUILDING <br />�esi�dence <br />EG�L DESCRIPf10N OF PROPERTY ISHOW BEIOW OR ATTACH FOUR COPIES� <br />LOT_BLOCK�OF <br />�oe �qg��s� Highland Avernxe <br />PLUMlINO <br />NO. TYPE OF FIXTURE OR ITEM FE <br />WATER CLOSET (TOILE7) <br />BATHTUB _ <br />LAVATORY (WASH BASIN) _ _ <br />SMOWER _ <br />KITCHEN SINK 8 DISP. _ <br />DISHWASHER <br />UUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL f <br />PERMIT f <br />TOTAL FEE f <br />SIDE YARD SETBACK STREET SETBACK REAR YARD S <br />USE ZONE LOT AREA VACANT SITE <br />;7YES ❑NO <br />TVPE OF CONST. OGCUPANCY GROUP NO. OF DWEL <br />SIZE OF BLDG. NO. OF STORIES MAX. OCC. L( <br />FIRE 20NE BASEMENT RIE�USRED KI <br />CYES ❑NO <br />APPROVALS Bt <br />1. ENVIRONMENTAL CHECK LIST <br />2 Bl11LDING PUNS <br />3. FIRE HYDRANT <br />1. FIRE PROTECTION SYSTEM <br />5. GRADING <br />8. DRAINAGE <br />7.ENVIRONMENTALIMPACT: <br />B. HEALTH DISTRICT <br />�PPUCATION ACC.BY <br />APPR. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPL�CATION AND KNOW THE SAME TO BE TRUE AND <br />GOVERN NG THIS TYPEIOF 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 />PERF�ANCE O� CONSTRUCTION. <br />cinu aF F CONTR R Ofl IY3t10RIZED AOENT DATE <br />J <br />MECXANICAL <br />AIH COND. UNITS — H.P. EA. <br />REFRIOERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAG <br />FORCED AIR SYSTEMS — B.T.U. <br />WALL HEATERS — B.T.0 <br />UNIT HEATERS — B.T.U. <br />CLOTMES DRVERS <br />VENTILATION FAN <br />RANOEHOOD <br />AIR MANDLING UNIT — <br />awvc — • <br />METAL FIREPLACE 6 CHIMNEY <br />FIREPUCE INSERT <br />HEAT PUMP <br />BUILDING <br />�AD <br />PLUMBING <br />.EiiS MECHANICAL <br />DATE OTNER <br />PENALTY <br />TOTAI <br />6J5/85 <br />FEE <br />EA. <br />ME <br />M <br />M <br />C.F.M. <br />SUS TOTAL � <br />PERMIT f <br />TOTAL FEE f <br />PLAN CHECK FEE <br />FEE RECEIPT N0. <br />VA�UATION FEE <br />S <br />303 (e) <br />PENMII vwuvwuvn � <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT _-- � <br />�� � `�' �� � �.��� <br />� <br />���� <br />i <br />ADDRESS FILE <br />