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fheEvcrgrecn - � C�'��VSTF�RJCTIOM - � � <br />CITY OF <br />ever��i PERMI� pERM1T NO.OH116 <br />pTY HALL 259�8745 <br />EVERETf. WA 98201 ❑ COMBINATION C�BUILDING ❑ MECHANICAL ❑ PLUMBING <br />CWNtR MAILADDRE55 CIIY IIP PHONE <br />Kenneth H. Bartley 690i Highland Drive 98203 353-4532 <br />RRCMRECTOR�ESIGNEH MAILApOPE55 CI7V ZIP FIIONE <br />GENERFLCANiPACTOP MPIL ADORE55 CITY ZIP PMONE UCENSE � <br />MEGHANIC4L GONTRACTOR MAI� qppRE55 CIiV ZIP PHCNE LqENSE I <br />Same <br />PLUAIBINGCONTRAGTOR MA�LADDR[$5 CITY ZIP "rMO�c LICENSEI <br />C1NEW ❑ADDITION ❑ALTERATIOPI ❑hiPAIR ❑DEMOLITION OFENCE ❑SI�N ❑GNRAGE <br />VAWATION OF WORK <br />5 80�.�0 <br />OESCPIBE WORH <br />reroof-composition <br />single fa.nily residence <br />LEGAL OESCRIPTION OF PROPERiY (SHOW BELOW OR ATiALH iOUR COPIES) <br />ior 19 n�a;�_or Beverly Hills Div. 1 <br />ighland Drive <br />PLUMBIN6 <br />SHOWEF <br />HEAIER <br />BREAKERS <br />AINS — RA <br />micc — aa <br />SIDE YARD <br />TYPE GF <br />OF BLDG. <br />S7REET SE7BACK <br />LOT AREA <br />OCCUPANCY GRC <br />N0. OF STORIES <br />eASEMENT <br />1. ENVIRONMENTALCHECKLIST <br />2. BUILDING PL4NS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SvSTEM <br />5. GRADING <br />fi. DRAINAGE <br />7. ENVIROP'MENTAL IMPACT STATEMENT <br />8. HEA'_TH DISTRICT <br />APPUCA710N ACC. BY PLANS CHECKED BV <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />Pl1�ATI0N AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />hLL PROVISIONS OF IAWS AND ORDINANCES GOVERNING TNIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />H[REIN 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 SiATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PFRFORMANCE OF CONSTRUCTION. <br />AiU EOFCONiR�CT�OR ° U1M�C AGENT /' DATE <br />X ��.. � �(., w/!� .r �A/. e 8�14�8� <br />TYPE OF EQUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRI(;FRATION 11NITS — H.P. LA <br />801LERS — HP EA. <br />GAS RRED AC. UNITS — TONNdGE EA. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />WALL HEATERS — B.i.U. M <br />IINIT HFATERS — fl T.U. M <br />EVAPORATIVE <br />VENTIlAT10N FAN <br />Alfl HANDLING UNIT — <br />METAL FIREPLACE <br />REAR YARD SETBACK PLAN GMhcK <br />VACANT SITE <br />❑VES ❑NO <br />NO. OF DWELLING UNITS <br />BUILDING <br />MA%.00C.LOAD <br />PLUMBING <br />FIRE SPRINKLERS <br />acnrnacn MECHFNICAL <br />APPR. FOR ISSUANCE BY <br />PLAN CHECK FEE <br />FEE I RECEIP7 NC <br />FEES I VALUATION I FEE <br />5 800.00 I 8 I00 <br />PENALT' U.B.C. <br />SEC.30310) <br />�� <br />WHEN PROPERLY VALIDATEC QN THIS SPACE� THIS IS VOUR PERMIT <br />6336 5008.OD -= -�} <br />, � <br />� <br />�`�::UR RtCCIPT� <br />� i'1 �11� � i�l� U <br />