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the Evergreen <br />GTY OF <br />� CC�ISTRUCTION .-� <br />everett PERMIT PERMIT N0. Oa1H6 <br />CITY HAL1269�tl/45 <br />EVERETf.WA 982U1 ❑ COMBINATION I�CBUILDING ❑ MECHANICAL C� PLUMBING <br />OWNER MIILApDRE55 CITV Zlf PHONE <br />Harold A Burrier 3319 Mukilteo Blvd Everett 355-2412 <br />PPCIIITECT OR DESIGNEP MAIL F�ORE55 GIiY ZIP PMONE <br />GENERALCANTRAC70R MnILADDPE55 GITY IIP PHONE LIGENSEI <br />Same <br />MECHANICAI CANiHACTOP MPIL ADDRE55 CITY ZIP PMONE UCENSE � <br />PLUMBINGCONTFACTOR MnILADDRE55 G1V ZIP PHONE LICENSEI <br />❑NEW <br />f $000.00 <br />OESCRIBE WORK <br />construct new <br />❑ADDITION ❑AL7ERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN �.I�•AMGE <br />ar <br />eingle family uaraqe <br />IEGAL IlESCRIPTION OF PPOPERTY �SHpW 9ElOW OR <br />�0�-6 BLOG�OF ShorE 9 <br />JOB ADDRESS <br />3319 Mukilteo Slvd. <br />PLUMBINQ <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET QOILEn <br />BATHTUB <br />LAVATORV (YJASH BASIN) <br />SHOWER <br />hITCHEN SINK G DISP. <br />DISHWASHER <br />LAUNDPVTRAY <br />CLOTHES WASHER <br />WATER NEATER <br />URINAL <br />DRINKING FOUN7AIN <br />FLOOH DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR. ETC.) <br />sue roui <br />SIDE VARD <br />, USE ZONE <br />TVPE OF G <br />V- <br />, �Z� pX�i <br />FIRE 20NE <br />3 <br />:TBACK STREET SE7BACK <br />7�x' 20' <br />LOT AREA <br />IST. OCCU?ANCY GRC <br />M-1 <br />, NO.OF STORIES <br />7. ENVu:ONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECiION SYSTEM <br />5. GFADIN6 <br />6. DRAINAGE <br />Z ENVIRONMENTALIMPACTSTATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION 4JC. BY PLANS CHECKED BY <br />V.C. <br />REAR VARD SETBACK <br />20' <br />VACANT T <br />7YE$ C <br />NO. OF DWELLING UP <br />1 <br />MA%.00C.IOAD <br />APPR. FOR ISSUANCE 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 COMPLIED N'ITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO G�VF. AUTHOFITY TO VIOLATE OR CANCEL THE PRO• <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGN�FTyUR/,E� OF CON�/RP/CiOR OR AUIHORIZEO AGENT � DATE <br />X///�fp ,rye�.C/�.C( �/L� e a/ 9/ 19 / 9 0 <br />� <br />MECHANICAL <br />N0. TYPE OF EOUIPMENT FEE <br />CAN�. UNITS — H P. EA. <br />RIGFRnTIOn UNITS — H.P. EA <br />�OILERS — H.P.[A. <br />GAS FIRED A C. UNITS — <br />FORCED AIR SYSTEMS — <br />WALL HEATERS — B T.U. <br />IINIT HFATFRS — B.T.U. <br />AIR HANDLING <br />METAL <br />80!8186 <br />BUILDING <br />PENALTY <br />M EA. <br />FEE 16.�� <br />a5000.00 <br />u.e.c. <br />SEC.303(a) <br />FECEIPT HO. <br />32 100 <br />32 100 <br />WHEN PROPEFLI' VALIDA7ED (IN THIS �ffjC�{ jH1515 �y�R�E/jMR O�_,� <br />tS U 6 11 L � <br />� <br />ti�,-_�uR r�cEip� <br />�i : l:��K YO U � - <br />2 2 s�a 8 U <br />ADDRE55 FILE '' <br />