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�: - �:��, <br />lheEvOigTYOF � -�:ONS�TRUCTIONr i ^ <br />everett PERMI� pERMIT NO. 08490 <br />CITY HALL 259�8745 <br />EVEREIT,WA 98201 ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBIN(i <br />OWNER MAILAODPE55 CITY ZIP PHONE <br />W.W. & Barbara L. Templin P.O. Box 206 Lynnwood 98036 <br />RRCHITECIORDESIGNER MAILADDRE55 CITY 21P PHONE <br />GENERAI CANTMCTOR MAIL fODRE55 dTY ZIP VNONE UCENSE � <br />Same <br />MECHANIf,A� �pNTRACTOR NAIL AD�RESS GTV ZIP PNONE LICENSE / <br />PWAIBINGCONTRALTOR MAIIA�DRESS CITY ZIP PMONE IICENSE� <br />❑NEW ❑ADC��TION ❑ALTERATION ❑FEPAIR �DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />f <br />�ESGRIBE \YOFlK <br />LEGAL OESCHIPfION OF PNOPERTY (SMOW 6FLOW OR ATTALH FOUR COPI':S� <br />�oT 13 e�oc�oF eeverly Park <br />JOB ADDPE55 <br />1726 <br />r�ursiNo <br />YP.HD SETBACK <br />USE <br />FIRE <br />t Drive <br />G <br />� <br />LOT AREA <br />1. ENVIRONMENTA� CHECK LIST <br />2. BUILDING PIANS <br />3. FIRE HVDMNT <br />4. FIRE PROTECTION SVSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMEN7ALIMPACT SfAT'cMENT <br />B. HEALTH DIS7RICT <br />APPLICATION A(,C. 8V 'IANS CHECKED BY <br />VACAIJT SITE <br />�YES ❑NO <br />APPR. FOR ISSUAYCE BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPIIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVF AUTHORITY TO VIOLATE OR CANCELTHE PRO• <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />X NAT����TpACTOR �� AU RIZED AGENi ORTE <br />�� (�,,t 10/27/80 <br />AIR fAND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />BOILERS — H.P.EA. <br />GAS FIRED A C. UNITS — TONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEA7ER5 — B.T.U. M <br />EVAFORATIVE COOLER$ <br />CLOTHES DRYEFS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANOLING UNIT — CF.M <br />STOVE <br />BUILDI41.; <br />PLUMBING <br />MECHANICAL <br />FEE <br />FEE <br />E <br />U.B.C. <br />SEC.303(e� <br />RECEIPT NO. <br />PROPERLY VPLIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />4126 a000.00 --� <br />� <br />`� � -'! �'. RcCEIPT o <br />'r'} �p�r�K YO �J <br />