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�he Evcrgrccn <br />CITY OF <br />-� C��NSTRUCTION <br />� <br />everet� PERMIT pERMiT NO.OH116 <br />CITY HALL 259�8745 <br />EVERETT. WA 9B20t ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEtt MAILADDR655 CItY ZIP PMONE <br />Kenneth H. Bartl?y 6901 Highland Drive 98203 353-4532 <br />ARCIIIT[CTOFCFSIGNEP MAILA�Uf1ES5 CIiV ZIP C40NE <br />GENEqALCONi�ACTOR MAIL/D�RE55 GITT 21P PHONE UCENSEI <br />MEGNANICALCANTRACTOA MPILAOOflE55 CITY ZIP PNGNE JCENSEI <br />Same <br />P�� MF31NG CUNTqACTOR MAI� ApORE55 CITY 21P PHONE LICENSE I <br />CLASSOF WORK <br />❑NEW ❑ADDI710N ❑AL7ERATION ❑REPAIR ❑DLI�OLITION ❑FENCE ❑SIGN ❑GARAGE <br />VAWATION OF WORK <br />S 8�0.�� <br />reroof-composition <br />single family residence <br />LEGAL OESCFIPTION OF PROPERiY (SHOW 2ELOW OP RRACM FDUP LOPIES) <br />�or 19 aiocK 1 oF Beverly Hills Div. 1 <br />ighland Drive <br />PLUMBIN�3 <br />KITCHEN <br />Y� <br />� <br />SIDE YARD SETBACK STHEET SEl <br />USE ZUNE LOT AREA <br />TYPEOFt:ONST. OCCUPANC <br />SIZE OF BLDG. NO. OF STC <br />FIRE 20NE BASEMENT <br />t. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYS7EM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPAGT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICA710N ACC. 8Y PLANS CHECKED BY <br />FEE <br />REAR YARD <br />❑VES ❑NO <br />I�Ic�:t�:4N <br />APPR. FOR ISSUANCE BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION 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 GRANTING OF A PERM�T DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />ATUI E OF WNiRAU-O�R 'UTM�O FGE1lT /� DATE <br />v ..__ . , � �`�/%i. .r �,/�. / 8/14/80 <br />TYPE OF E�UIPMENT <br />AIR CAND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />BOIIERS — H.P. EA. <br />GAS FIRED AL. UNITS — TONNAGG EA. <br />FORCED AIH SYSTEMS — B.T.U. � <br />\vALL H[i SEFS — B T.LL � <br />LIuIT HCATERS — B T.U. I <br />VENTILATION FAN <br />RnNGEHOOD <br />AIR HANDLING UNIT — <br />8 CHIMNEY <br />SUBTOTAL <br />PLAN CHECK FEE <br />FEE � RECEIPT NO. <br />FEE <br />BUIL�ING I$ 800.�0 � $ IQQ <br />PLUMBING <br />U.B.C. <br />SEC. 303 (a) <br />WHEN PROPERLY VAUDITED (M THIS SPACE) THIS IS VOUF PERMIT <br />6336 5008.00 --`�i <br />C—I <br />� <br />Y!"_, U R RECGIPT � <br />i I I.�f�� i�0 U <br />ADDRESS FILE I 1� AUG 8O <br />