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Me Evergreen <br />( / "I1 f (V ]' <br />ST R Y <br />/ <br />N <br />an of <br />\ {li <br />V 1, <br />V) <br />everett <br />PERMIT <br />PERMIT NO.O9738 <br />CIT1 HALL 259.8745 <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />•X�tPLUMBING <br />EVER TF, WA 98201 <br />OWNER MAIL ADDRESS <br />Lawrence A Barthel 4208 South 3rd Avenue <br />CITY <br />Everett <br />98203 <br />259-5252 <br />ARCHITEC' OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE IICENSE4 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE IF <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE( <br />Same <br />y _ - ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />S <br />replace water line from <br />property line <br />to residence <br />PROPOSED USE OF BUILDING <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 WORM. 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 />SIGNATU OF CONTRACTOR OR AUTHORIZE' O AGENT DATE <br />X 9/2/81 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT BLOCK —OF <br />41�a8DSouth 3rd Avenue <br />PLUMBING <br />CHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (IOILET) <br />AIR COND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS - H.P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS - TONNAGE EWEA <br />KITCHEN SINK 8 DISF. <br />FORCED AIR SYSTEMS - B.T.U. <br />DISHWASHER <br />WALL HEATERS-B.T.U. <br />U IJNDRY TRAY <br />UNIT HEATERS -BTU. <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE -BAR ETC.) <br />SUB TOTAL <br />2 <br />00 <br />SUB TOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />i <br />q <br />Ark <br />TOTAL <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT 140. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES LINOFEES <br />VALUATION <br />FEE <br />TYPE OF CONST, <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />1. ENVIRONMENTAL CHECK LIST <br />2, BUILDING PLANS <br />3. FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />5. GRADING <br />G. DRAINAGE <br />T ENVIRONMENTAL IMPACT STATEMENT <br />8, HEALTH DISTRICT <br />APPLICATION ACC. BY I PLANS CHECKED BY <br />BY DATE <br />PENALTY SEC. k3 (O U.B C. <br />TOTAL S OO <br />PERMIT VALIDATION <br />WHE14 PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT <br />00 <br />0 <br />APPR. FOR ISSUANCE BY � i <br />i <br />ADDRESS FILE <br />