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the Evergreen CITY OF r 7 NSTR U CTIO N <br />everett PERMIT <br />CITY HALL 259-8745 PERMIT NO. 08944 <br />EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING IQ MECHANICAL ❑ PLUMBING <br />OWNER <br />ehu <br />ZIP Bette Fairfield 1901 Pin <br />MAI-ehu'55 CITY <br />rst PHONE <br />ARCHITECT OR DESIGNEq MAIL ADDRESS <br />CITY ZIP PHONE <br />MAIL <br />Natural Gas Equipment 1611 East" CITY Grand Everett 982Z01 258'-2E441 CENse.' <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />CITY 21P PHONE LICENSE <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />S <br />LL..L ULSGRIPTION OF PROPERT <br />LOT BLOCK -OF <br />1901 RKUHiUNK Pinehurst <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITFI <br />USE <br />DISP. <br />SETBACK I STREET <br />13YES <br />Kli&i7 <br />OF BLDG. I NO. OF STORIES -MAX <br />1. ENVIRONMENTAL CHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINACE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICA— N AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL P, SIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />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 REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUR�E�9I�/s!�eI ACTOR O U7 ORIZED AGENT DATE <br />X �/h a 3/2/61 <br />FEE N0. TYPE OF EQUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />BOILERS — H.P. EA. <br />GAS SIRED A.C. UNITS — TONNAGE EA <br />FORCED AIR SYSTEMS <br />_ WALL HEATERS — B.T.U. M <br />_ UNIT HEATERS —B.T.0 M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />APPLICATION ACC. BY I PLANS CHECKED BY I APPR. FOR ISSUANCE BY <br />AIR <br />[3 <br />FEE <br />BUILDING I S <br />PLUMBING <br />C F AI <br />FEE <br />FEE <br />RECEIPT NO. <br />7 50 <br />OTHER <br />PENALTY U.B C. <br />SEC. 303(a) <br />TOTAL 7 50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />4690 SO07,50 <br />CD <br />CI IPTo <br />