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''"`'"'""" - C�`NSTF�UCTION - <br />��r, oF <br />everett PERMIT pERMIT N0. OS21� <br />CI7Y HALL 259�8745 <br />EVERETT.INA �ezoi ❑ COMBINATION ❑ BUILDING ❑ MECHANIC��L ❑ PLUMBING <br />OIYNER - MNILRO�RE55 CIiY ZiP PHONE <br />Vern Ren 5403 3rd Ave. So. Everett 98203 259-2772 <br />ARCHIi[CT OR DESIGNER AIAII AD�RE35 CI1Y ].IP PHONE <br />GENERALCONIRALiOR MAqADOR[55 CIiY ZIP PHON[ lILE115EI <br />Everett Builders 5606 Evergreen t9ay 98203 353-7161 223-01-EV-ER-EB-307. PH <br />MECNANiCAI CONiRAClO�i AUIL ADORC55 QiY 21P PHON[ UCENSE � <br />1'LU61pINGCONTFACtOR MAIL/DDRESS GiV ZIP PHONE LICENSE� <br />I]NEW ❑ADDITION ❑ALTERATION <br />VRLUAiION OF 140RN <br />s1380.00 <br />oescaioe woaK <br />Reroof (3 Ply Het Asphalt) <br />PAOPOSEU USE OF BWL�ING <br />Residential <br />IEGAL OESCRIPiION OF CpOPERiY �SN01Y pEL01Y OR ATTACII FOUR COPIES� <br />ior�p_niocrc2.b—oF m.,�.,,, .,F •.c..Toii <br />JOfi ADDRE55 <br />5403 3rd Avenue S. <br />PLUMBING <br />EiATHTUB <br />lA\'ATORY IWASH BA <br />SHOWEa <br />KITCHEN SINK F 015! <br />DISH WASHER <br />Lf�UNDRY TRAV <br />CLOTIIES WASHEf7 <br />\YAiER HEATER <br />URINAL <br />DfiINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUU618REANERS <br />ROOP DRAINS — RM�. <br />5!NN ISERVICE — BAI <br />SIZE OF BIDG. <br />FIPE <br />RE OR ITEM <br />C�REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS �P� <br />PLICATION AND KNOW THE SAME TO BE iRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF q PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTfiUCTION OR THE PERFORMANCE OF CONSTRUGTION. <br />SiGNAIURGOFGONPNCIO�"p4iAUiHORiZE'PG[Ni DAiE <br />1 <br />X �h,-,���-�1 ��;,,,.� '�t:� 9-4-eo <br />° � r <br />MECHANICAL , <br />NO. TYPE OF E�UIPMENT FEE <br />AIR COND. UNITS — H P EA �— <br />RFFRIGFRATION IINITS — H P PA � <br />Gn5 FIP[U A C. UNITS — TONNAGE EA. <br />FORCFf) AIR SYSTE�dS — l3 T U. M <br />WALL HEAT[RS — B T.U. M <br />LINITHFFTFRS—ATII M <br />CLOTHES ORY[RS <br />VEN�ILATION PAN <br />STOVE <br />META� <br />STREET SET�ACK I REAR VARD :''r�ACK IPL4N <br />LOT AREA <br />BASEMENT <br />VACANT SITE <br />LiVES :]NO <br />GROUP NO. OF U'NELLING UNITS <br />— GFM <br />PERMIT <br />FLE <br />BUILDING £ <br />.'. OCC. LOAD <br />PLUMBING <br />IE SPRINKLEFS <br />OUIRED MECNANICAL <br />BV I OATE <br />L ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIRE H"DRANT <br />4. FIRE PROTECiION SVSTEM <br />5. GRADING <br />G. DRAINAGE <br />i. ENVIRO�M[NTALIMPACTSTATEMENT <br />8. HEALiH DISTRICT <br />APPLICATION ACC. �Y PIANS CHECKED BV APPR. FOR ISSUANCE BY <br />7y UBC <br />SEC.303(e) <br />FE[ <br />RECEIPT NO. <br />FEE <br />14 I 00 <br />WHEN PROPERLY VALI�ATED pN THIS SPACE) THIS IS VOUR PGRMIT <br />7171 E � � G. � U,--- �1 <br />c '� <br />N <br />`�':�. UR RECEIFTo <br />� ' '�, �J : 1' C U <br />-qs�80 <br />�DDRE;S FIL[ <br />