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the Evergreen ,, CONSTRUCTION ---�. <br />an oF <br />everett PERMlT PERMIT NO. 0�504 <br />CITY HALI 259�8745 <br />EVERETf, WA 982D1 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEP MAILRUORE55 GTY ZIP pppryE <br />Elbert V. Edwards 1036 Grandview 98203 252-5643 <br />�RCHITECT OF DESIGNER MRI� ADDRE55 CITY IIP pqpqE <br />GENEMI CANTMCTOR MAIL ADDRESS dTV ZIP PHpHE UCENSE I <br />$� <br />MECHANICALCONiIULTOR MRiL�DDRE55 CITY 21P RIONE LICENSE� <br />PLUMBINGfANTRACTOR MAILADDPESS qry ZIP PHONE LICENSE� <br />ClAS50F WOpK '� <br />❑NEW ❑ADDITION ❑ALTERA710N �FiEPAIF ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAf;E <br />f 1017.00 <br />DESGRIBE WOIiK <br />re-roof <br />raoPoseo use or euao <br />l0T Z ALOC�OF <br />reeidence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />JW BELOW ORATTACM FOURfAPIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />Terrace ALL PROVISiONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF W(JRK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />F!=REIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />P� �ESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATIN� <br />CONSTRUCTION OR THE PERFORMANCE OF CANSTRUCTION. <br />SIGN/�jyREQFfANTRACjO�jAUjI1BR2EQAGENT DATE <br />1036 Grandview Avenue <br />rwMsow <br />KITCMEN <br />rn�v <br />� <br />� <br />OF flxTURE OR ITEM <br />� �g.t, '�;' i SIDE VARD &EfBACK S7REET SI <br />ti .� <br />K�'� ���-t � USE ZONE LOT AREA <br />uiNa , <br />. , NPE OF CONST. OCCUPAN <br />SIZE OF BLDG. NO. OF ST <br />FIRE ZONE 9ASEMEN' <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE IiVORANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTALIMPACTSTATEMENT <br />e. HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />X <br />FEE <br />VACANT SITE <br />❑YES ❑NO <br />NO.OF DWEL <br />sr <br />AIR CAND. UNITS — H.P. EA. <br />REFRIGERATION 11NITS — H. <br />GAS FIRED A'C. UNITS — <br />FORCED AIR SVSTEMS — <br />WALL HEATERS — B.T.U. <br />UNIT MEATERS — B.T.U. <br />EVAPORATIVE COOLERS <br />CHECK NUMBER <br />PENALTY <br />TOTAL <br />APPR.FORISSUANCEBY <br />FEE <br />M EA. <br />E 1017.00 <br />U.B.C. <br />SEC. 303 (a) <br />s <br />FEE <br />RECEIP7 NO. <br />M�■ � � <br />11 � 00 <br />PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERIAIT <br />i3oo s011,00—� <br />. � <br />N <br />�'O U�R RECEIPT � <br />THAf�JK YOU <br />ADDRESS FILE <br />24�80 <br />0 <br />� <br />