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`'1e`"CTYCOF � ^ONSTRUC�ION � <br />everett PERfJiIT pERMIT N0. O96Z5 <br />CITY HALL 259�B7A5 <br />EVERETT. WA 98201 ❑ COMBINATION C�BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILAUDRE55 CITY ZIP PIIONE <br />Gladys Keith 809 Grand 98201 252-9267 <br />FRCNITECT OP DESIGNEfi MFII AD�RE55 CITY ' 21P PIIONE <br />GENEPALCONIFACTOR MAIIADORE55 CITY ZIP PMONE ULENSE♦ <br />Same <br />MECHANICALCANiRACiOR MAILFDDRE55 CITY ZIP FHONE LICENSEI <br />PLUMBINGGONTRACTON MAILAODRESS CITY 21P PHONE LICENSEI <br />CLF55OF WORN <br />❑NEW �A�DITION ❑ALTERATION IR�PAIR ❑DEMOLITION ❑FENCE ❑SIGN �GARAGE <br />VALUATION OF WOPN <br />5 LrJ�.O� <br />DESCRInE WORH <br />reroof qarage-shake <br />PROPOSEU USE OF BUILDING <br />sinale familv residence I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS AP- <br />LOT 3 BLOCK17� OF <br />809 Grand <br />PLUMBINO <br />(SMOW BELOW ORATTALM FOURGOPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />Swallwells 6th TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN 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 STATE OR LOCAL LAW REGUTATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNRTURE NTPFCTO����ZE�FGENT �ATE - <br />x n �in�� oad��e�io�ei <br />TYPE OF FIXTURE OR <br />FOUNTAIN <br />BREAKERS <br />AINS — RA <br />ivifF — Rt <br />SIDE YARD SETBAGN STREET SE7 <br />USE ZONE LOT AREA <br />TYPEOPCONST. OCCUPANC <br />SIZE OF BLDG, NO. OP STC <br />FIRE ZONE BASEMENT <br />1. ENVIRONMENTAL CHECK �IST <br />2. BUILOING PLANS <br />3. FIRE HYDRANT <br />d. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAG[ <br />7. Fr:\'�PNJf,�.rr.,..,� p��.._. :�. � .�ri�_ <br />FEE N0. TYPE OF E�UIYMtNI <br />AIR COND. UNITS — N.P. EA. <br />REFRIGEFlATION UNITS — H.P. EA <br />BOILERS — HP. EA. <br />GAS FIRED AC. UNITS—TONNAGE EA <br />FORCED AIR SYSTEMS — BT.U. M EA. <br />WALL HEATERS — B T.U. M <br />UNITHEATEtiS—BT.U. ti� <br />EVAPORATIVE COO�ERS <br />REAR YARD <br />❑YES <br />MAX. <br />FEE <br />FEES �ALUATION <br />BUILDING S 150.00 <br />PLUMBING <br />lAECHANICAL <br />PENALTY <br />TOTAL <br />U.B.C. <br />SEC.303�a) <br />FEE <br />RECEIPT N0. <br />FEE <br />.... ""'_""_" <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />� <br />N <br />Y� <br />