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L <br />theEvergreen - ^ONSTRUCTION - � <br />CITY OF <br />everett PERMIT pERMIT NO. 11515 <br />GTV HAIL 259�8745 <br />EVEREI?. \VA 98201 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OrYNER MAILApDRE55 CITY 21P PHONE <br />ELBERT ELLFR 6314 Highlat,d Drive Everett i4A 353-4241 <br />AFCHRECT OR DESIGNER MAIL nDDNE55 CIiY ZIP pMONE <br />GENERAL CANTRACTOP MRII ADDRESS CRY 21P P40NE LICENSC I <br />MEGNANICALCONTRnCTOR MAILADDFESS CITY ZIP PHCNE ' LIGENSEI <br />Gas Appliance Service 1103 N. 36th St Seattle 98103 632-5000 GASAPI*371NT <br />PWMBINGCONIRACiO� MA�IADCAiSS ;,iY 2iP �CNE LI.ENSE� <br />❑NEK J ,�ADDITION ❑ALTER4TION ❑REPAIR ❑DEMOLITION ❑'ENCE ❑SIGN ❑GARAGE <br />VALUATION Of WORK <br />S <br />DESCRIBE WOPN <br />Install natural gas furnace and water heater <br />PFO!'OSEO USE OF BUIIDING <br />Residence I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS AP- <br />�or e�aK_oF <br />6314 Hi <br />PLUMBINO <br />NO. <br />land Drive <br />TVPE OF FIXTURE <br />SHOWLR <br />KIiCHEN SINK 8 DISP. <br />OISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAI. <br />DRINKING FOUNTAIN <br />FlOOR DRAIN <br />VA�i:uM BREAKERS <br />ROOf DRAINS — RAINLEADERS <br />SINK �SERVICE — BAR ETC ) <br />SUB TOT <br />SIDE VARD SETBACK <br />USE ZONE <br />TYPE OF CONST. <br />512E OF BLDG. <br />FIRE ZONE <br />ORATTACNiOURCOPiLS) PLICATION AP1D KNOW THE .`'ME TO BE TRUE AND CORRECT. <br />r\LL i 90VISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />— T'rPE G° WORK WILL 9c COMPLIED WITH WHETHER SPECIFIEI) <br />IIEREIN OR NOT. fH[ GRANTING OF A PERMIT DOES N��� <br />PRESUtiIE TO GINE AUTHORITY TO VIOLATE OR CANCEL THE rflC•- <br />VISIONS OF AtJY OTHER STATE OR LOCAL LAW REGULATIN;i <br />CONSTR�^.TJ9N OF E PERFORMANCE OF CONSTi;UCTION. <br />SIGNATURE P ORFUTr1�RREDAGENT OAiE <br />X 2/15/83 <br />STREET SETBACK REAR YAflD SET[ <br />LOT AREA VACANT SITE <br />I;VES LiNO <br />OCCUPANCY GROUP N0. OF DW'ELLIN <br />NU. OF STORIES MA% OCC. IOAD <br />BASEMENT FIRf::PRINKLER'. <br />REOU15E0 <br />f]YES C7N0 <br />ivALS BY DATE <br />t. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />�. FIRF. HVDRANT <br />a. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIFONMENTALIMPACiSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICPTION ACC. BV PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />AIR <br />TYPE OF EQUIPMENT <br />1NIiS — HP. EA. <br />'ION UNITS — H.P. EA <br />G45 fIRED AG UNITS —TONNAGE EA. <br />FORCED AIR SVSTEMS — 8.T U. � M <br />WALL HEATERS — B TL. 61 <br />UNIT HEATERS — 8 T.U. M <br />EVAPORATIVE COOLERS <br />VENTILATION FAN <br />AIR NANDLING UNIT —� <br />METAL <br />FEE <br />FEES V <br />BUILDING E <br />PLUMDING <br />MECHANICAL <br />PEIdAii'1 <br />U.B.0 <br />SEC.3031a) <br />FEE <br />RECEIPT NO. <br />�11 <br />�� � <br />PROPERLY VALIDATED (IN THIS SPACE) THIS IS VOUR PERMIT <br />3rIS 5018.00--=� <br />� <br />YOUR REG�EIPT � <br />THANK YOIi <br />ADDRESSFILE <br />I 5 � 83 <br />� <br />J <br />