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, . , <br /> rhe£vergreen �r., ���y ST R U CT I O N -� <br /> CITY OF <br /> eve�ett PERMIT PERMIT N0. OH7Z4 <br /> CITY HALL 2�9�8745 <br /> EVERETT,WA se2o� ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> OWNER MAILAODRESS QiY ZIP P��ONE <br /> E. A. Desy )_412 Par.k Drive 98203 353-6212 <br /> AM;HrtEGTORDES'GNER MRILADDAF'S CITY ZIP PH01lE <br /> GENEPAL CONTMCTOIi MAIL ADDRE'S pTY 21P PHONE I�CENSE I <br /> MECMANIGI CANTRALTOR AIRII ADpRE55 CRY ZIP PHONE LICENSE I <br /> • <br /> PLUM�ING CAY7RALiOR IAAIL A�DRE55 CITY ZIP PNONE LIGENSE� <br /> C'.i1550F WOFK <br /> ❑NEW ❑ADDI710N ❑ALTERA710N �REPAIR ❑DEMOLITION ❑FENCE GSIGN ❑GARAGE <br /> VAWATION OF WORK <br /> f <br /> DESCRIBE WORN <br /> PROF'OSEO USE OF UUIIDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> LEGAL DESCRII'iION OF 1'ROPENTY ISHOW BELOW ON ATfACN FOUR COPIES) PUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERYING THIS <br /> �or e�oc�_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. 7HE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CAN(:EL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LO LAN REGULATING <br /> CONSTRUCTION OR THE ERFORMANC C� oTRUCTION. <br /> SIGNqTUPE 0 ACtOR OR AU iORI nGENi DATE <br /> '��°�'E�ark Drive X � e 12/29/80 <br /> PLUMBINO ME HANICA <br /> � NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSEf(LOILEq AIR COND.UNRS—H.P.EA. <br /> . BATHTUB REPRIGERATION UNITS—HP.EA <br /> LAVATORY ASH BASIN) dOILERS—H.P.EA. <br /> SHOWER GAS FlRED A.G.UNITS—TONNAGE EA. <br /> KITCHEN SINK 6 DISP. FOPCED AIR SYSTEMS—6 T.U. M EA. <br /> DISHWASHER WALL HEATERS—B.T.U. M <br /> LAUNORV TRAY UNIT HEATERS--B.T.U. M <br /> CLOTHEStYASHER EVAPORA7IVE COOIERS <br /> VlATER H[ATER CLO7HE5 DRVERS <br /> URINAL VENTI�iION FAN <br /> DRINKING FOUN7hIN RANGE HOOD <br /> FLOOR DRAIN AIR HANOLING UNIT— C.F.M. <br /> VACUUMBREAKERS �. S70V[WOOd <br /> ROOF DRAINS—RAINLEADtRS METAI FIREPLACE 8 CHIMNEV _ <br /> SINK(SERVICE—BNR.ETC.1 <br /> SUBTOTAL SUB TOTAL f 4 S <br /> PERMIT f PERMIT f <br /> TOTALFEE f TOTAL FEE S <br /> S�C`c YARD SETBACK $TREET SETBACK REAR YFRD SETBACK PLAN CHECK NUM1I�ER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> �SE ZONE LOT AREA VACANT SITE � <br /> OYES f7N0 FEES VALUATION � FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES �.�A%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE &15EMENT pEOUIRED KlERS MECHANICAL 7 5 0 <br /> ❑YES �NO <br /> APPNOVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.9.C. <br /> — SEC.303(a) <br /> 2. BUILDING F'�1NS <br /> TOTAL � 5 0 <br /> 3. FIRE HYDRANT <br /> 4. FIRE PROTEC710N SYS7EM PENMIT VALIDATION <br /> - \YHEN PROPLRLV VALIDATED(IN THIS SPACE)THIS IS VOUR PERMI7 <br /> 5. GRADING 2 2 � � R O O l. ) O —NT{ <br /> 6. DRAINAGE <br /> 7. ENVIRONMENTAL IMPACT STATEMENT ~ . <br /> B. HEALTHDISTRICT ' �. '.� i� n��(� f_�PT� <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOF ISSUANCE BY ' ;:�^ },t./ U <br /> V,C. <br /> r <br />