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, <br /> theEvergreen � CANSTRUC�'ION r �, <br /> CITY OF <br /> everett PERMIT PERMIT NO. OH692 <br /> CITV HALL 259�8745 � COMBINATION ❑ BUILDING k� MECHANICAL ❑ PLUMBIN(i <br /> EVERETT.WA 98201 <br /> OWNER MAIL ADORE55 <br /> CITY ZIP PMONE <br /> Lillian Binnall 914 Peck' s Drive Everett ZP PNONE <br /> MAII ADORE55 ��TY . <br /> ARLHITECT OR DESIGNER � <br /> GENERAICONTRACTOR MAILADDRE55 <br /> CITV ZIP PMONE UCENSE 1 ' <br /> MAIL ADDRE55 CITY ZIP PNONE LICENSE� <br /> MECHANIGL CANTRACTOR 2 5 8-2 4 41 <br /> Natural Gas Equipmant 1611 East Grand Everett ZP pHONE L�CENSE� <br /> PIUMBING CANTRACTOR <br /> MAIL A�DFESS ��TY � <br /> �1qS50F WOfIK <br /> ❑NEW ❑ADDITION ❑A�TERA710N ❑FEPAIR ❑DEMOLITION OFENCE ❑SIGN GARAGE <br /> WLUATION CF WORK <br /> f <br /> DESCPIBE WOPI( <br /> PRO�OSED USE OF BUIIUING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEW�OESLRIPTION OF PROPERTY ISMOW BELOW OR Ai1AGH FOUR W�'IES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �oT e�a�c._oF 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 /> CO STRUCTION OR THE PERFORMANC�OF CO STRUCT ONNG <br /> onTe <br /> . � SIGNPTUREOFWNTRCTORORAU OFREDA t 1Z�ZS�HO <br /> ' ' . .q8�UDt1E55 <br /> . 914 Peck' e Drive <br /> . .� -� � ANICAL <br /> � pIUMNNO FEE <br /> � � � � N0. Tr�E OF FIXTURE OR REM FEE N�� p�P CAND.Uw SE OH pOUIPMENT <br /> i <br /> '� � �' ' .' WpTER ClOSET OIL qEFRIGERATION UNI�S—H.P.EA <br /> . . , . . 1 BATHTUB ��� <br /> . , � BOILERS—M.P.EA. <br /> UVATORV ASH BASIN i <br /> � � GAS FIRFD A.C.UNIiS—TONNAGE FA. <br /> �. � - . ���R FORCED AIR 51'STEMS—B T.U. M EA. <br /> • -� KITCHEN&NK 8 DISP. M � <br /> � . WALLHEATERS—BT.U. <br /> ., __ ��$�WA$MER UNIT HEATERS—B T.U. �� <br /> � . UUNDRV 7MY EVAPOFW7IVE COOLERS <br /> � - . CLOTHES W�HER CLOTHES�RYERS <br /> � . � WATER HEATER VENTILATION FAN <br /> . i URINAL RANGE HOOD <br /> ,- DRINKING FOUMAIN plq NANDLING UNIT— C.F.M. <br /> � �, FLOOR DRIUN <br /> STOVE <br /> . VACUUM BREAKERS METAL FIREPLACE 6 CHIMIlEV <br /> � ROOF DMINS—M�NLEADERS <br /> � I SINK(SERVICE—B�R.E1C.) 1 <br /> � <br /> i <br /> SUlTOTAL <br /> SU/TOTAL PERMIi <br /> PERMR S TOTAL FEE 7 S O <br /> - TOTAL FEE S . PLAN CHECK FEE <br /> SIDE VAHD SETBACK STREET SETBhhCK REAR YhRD SE7BACK PLAN CHECK NUMBER qECEIPT NO. <br /> FEE <br /> USE ZONE LOT AREA VACANT SITE F�g VALUATION FEE <br /> ❑YES �NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCG.LOAD <br /> PLUMBING <br /> FIRE ZONE B0.SEMENT FIRE SPIiINKLERS MECHANIGL � S O <br /> REOUIHED <br /> OYES ONO <br /> • !Y DATE �HER <br /> AppR0VAL8 <br /> PENALTv U.B.C. <br /> 1. ENVIRONMENTAI:HEGK LIST SEC.3U3(a) <br /> 2. BUILDINGPlANS TOTAL 7 50 <br /> 3. FIHE HYDMNT <br /> �ERMR VALlDAiION <br /> �. FIRE PRO7ECTION SVSTEM WHEN PROPEPLY VALIDATED(IN 7HI5 SPACE)THIS IS�OUR PERMIT <br /> 5. GRA�ING <br /> 1 � 70 $ 007. 50 -�! <br /> 6. DRAINAGE (D <br /> 7. ENVIRONMENTAL IMPACT STATEAIENT <br /> B. HEALTH DISTRICT �. �' = �' R'-C E I PTO <br /> APPLIGTION ACC.BY PLANS CHECNED B� APPR.FOR ISSUANCE BY . ' l'_1��1� Y C U . <br />