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.�:� . ,CI7YOF �V �V � ��� � ■V�\ <br />everett � <br />PERMIT PERMIT NO. 093�7 <br />CITY HALL 259-B7d5 <br />eveaerr.wn eezo� ❑ COMBINATION �x�tS�11iDING ❑ MECHANICAL ❑ PLUMBING <br />OYJNER M1IAILADD9ESS CITY Z'�P PMON6 <br />Sybil Johnson 2415 Rockefeller Everett 98201 259-2005 <br />nflLHITECT OR DESIGNER MAIL nDDPE$5 CiiY ZIP PHONE <br />GENERlLCONTRACTOP IAAIL4DORE55 ❑iY ZIP PHONE L�CENSE� <br />Same <br />MECHAMGAL CONiRACTOR MAIL AppRESS CiTY ZIP PNONE I�CENSE I <br />PLUAIBINGCONTRACTOR MAILADDRESS GITY ZIP PIIONE UCENSE/ <br />LLA55 OF WORK <br />❑NEW <br />a 500.00 <br />❑ADDITION ❑ALTERATION �REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />comp re-rooP <br />aaoroseo use oF omioirvc <br />single family residence <br />l[GAL DESCRiPTION OF PROPERtt �SMOW BELOW OR <br />�or 8'9 e�oc� SSBF Everett <br />�oe nooeess <br />2415 Rockefeller <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />BATIiTUO <br />SHOWER <br />DISH\YASMER <br />VACUUM BREAKERS <br />ROOF DRAINS — RAIN <br />SINK ISERVICE — BAR. <br />SIDE YARU SETBACK � STREET SET�ACK <br />USE <br />TVPE OF CANST. <br />SIZ{ pF BLDG. <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />9. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5 GRADING <br />6. ORAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />0. HGALTH DISTRICT <br />APPLICAi ION ACC. 6V PLANS CHECKED BY <br />REAR YARD SETDACK <br />❑YES f;NO <br />NO.OF DWEI <br />MAX.00C.LOAD <br />SPRINKLERS <br />APPP. FOR ISSUANCE BY <br />I HEREBY CERTIFY THAT I HA'JE READ AND EXAMINED THIS AP� <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LA�VS F,ND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPEGIFIED <br />HEREIN OR NOT. THE GRAtaTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OT R STATE OR LOCAL LAW REGULATING <br />CONSTRU ON OR THE ERFORMANCE OF COtJSTRUCTION. <br />SIGNNIUAE� O/NiRf�CiOfiOflAUTWRIZED -NT OATE <br />X 5����✓ .�-r�� 6/ 2/ 81 <br />' TFPE OF E�UIPMENT <br />AIR COND. UNITS — HP. EA. <br />RFFRI�FRATION UNITS — H.R EA <br />�OILERS — H.P EA. <br />GAS FlfiED AQ UNITS — TONN <br />FORCED Alq SVST[IdS — BSL. <br />V�ALL HEAi[RS — 9.T.U. <br />UNIT H[ATLRS — �.T.U. <br />EVAPOPAINL COOLERS <br />VENTIL�TION I <br />RANGEHOOD <br />AIR HANDLWC <br />BUILDING <br />PLUMBING <br />MECHANIGAL <br />OTHER <br />PENALTY <br />TOTAL <br />M <br />M <br />FEE <br />FEES VALUATION <br />b 5�0.�0 <br />U.B.C. <br />SEC. 303 (a) <br />RECEIPT N0. <br />PERMIT VALIDATION <br />WHLN PROPERLY VALIDATED (M THIS SPACE) THIS IS YOUR PERMIT <br />;',i �. ��.`'� <br />�� DRESS FiLE <br />�, i <br />