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d�e l��ergreen L J h,;T R U CT I O N <br />cirr oF <br />everett PERMIT pERMIT N0. OS522 <br />CITV HALL 259�8745 <br />eveaen.•,vn �ezoi ❑ COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OC.'NEfl MAILADDHE55 GIP ZIP P��ONF <br />nnh arm�tina� ,40? so. 3rd Everett, Wn. 252-7859 <br />APC11R[QCR�CSiuNCR AIAILAODRE55 CI1V Pa PHONE <br />F..P,-arr nn;IAPYF 7nc_ 5606 Evergreen Way Everett 353-7161 <br />GCIIEPALCANi1.�CTOR MP" \pDPE55 �I1V ZiP PNONE LICENS(.r <br />6',ECMANICALCONiRACiOR AIAILADDRESS CiJy ZiP FHONE UCE��SE • <br />PLWABIhGLONiRACiOR MAILADDRE55 CIiV ZiP PHONE UC_HSir <br />❑NEW ❑ADDITION ❑ALTERATION �REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />S 6400.00 <br />oEscaieE woaK <br />New Cabinets & floorin & countertop (Kitchen Remodel) <br />�noroseo use oF oui�ou+c <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />�ecnioesca��nonoraaonarrrs��avoE�owoannnc�veunwr�is PLI:,ATION AND KNOVJ THE SAME TO BE TRUE AND CORRECT. <br />ALL FROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />�or i eioc '' oF TYPE OF WORK WILL BE COMPLIED WITH WHETHEfi SPECIRED <br />HEREIN OR NOT. THE GRANTING OF A PERtv11T DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER-ST-A OR L�AL LAW REGULATING <br />CONSTRU 710N OR THE PERF MANC O CONSTRUCTION. <br />dou t�oDaESs si,Nnt i+.r: qvru6cto o�+t.uU . rEo nr,tNT u4i[ <br />5402 So. 3rd St. X J ` ) '<- -'-,7�'-"'�� <br />PLUMBING � . MEC �ANICAL �- <br />TYPE OF <br />L.AVATORVfWFSH <br />LAUIJOf7Y TRAV <br />UFINAL <br />[7RINKING FOUNTAIN <br />ROOF DRAINS — RAINLEAC <br />SINK iSERVICE — DAR ETC <br />SID[ YARD SETBACH <br />TYPE OF CONST. <br />SIZE OF BLDG. <br />FlRE ZONE <br />STREET SETBACK <br />LOT AH[A <br />t ENVIRONMENTALCHECKLI"aT <br />2. �UILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5_GRADING <br />G DRAINAGE <br />� ENVIRONMENTAL IMPACi STATEMENT <br />�3. HEALTH DISTflICT <br />APPUCATION ACC. BY PUN$ C4ECNED �Y <br />FEE <br />R[nRVARD <br />IlYES ❑NO <br />LOAD <br />BY I DATE <br />APPq.FORI55UANCE BY <br />NEfR�G[RATION UNIiS— <br />OOILERS — HP. E�. <br />GAS FIRED AC. UNITS —' <br />FORCFD AIR SY ;TFMS — I <br />UNITLHEAT[RS — �SL. <br />EVAF'ORATWE COOLERS <br />AIP HANDLING UNIT — <br />SUBTOTAL <br />PEPMIT <br />TOTAL FEE <br />NU67BER <br />F[E <br />FEES VAL <br />S <br />EA <br />C.F.M <br />CE <br />NECEIPL NO <br />PENALTY U BL. <br />SEC.'�3 (al _ <br />70TAL <br />_ ti2 50 <br />PERMIT VALIDATION <br />WHEN PftOPEFLV VALIDATED �RJ THIS �PAGFI J��1515 �'Ol'H�P�iIA�I � � ,� <br />N <br />N <br />L(') <br />� � i 1 � <br />�� � <br />,��,��_.."_ ,.�. ,_ <br />. .. ..._.� i � .- <br />` �; <br />