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!h�• Llrrr��rreri <br />��� ':ONSTRIiCTlO�' <br />e�erett PERMIT PERMITNO. �-21��J <br />CR Y HALL :59-B7d5 <br />eveaE�T,�vnsezoi � COMBINATION �I BUILDING ❑ MECHANICAL ❑ PLUMBING <br />o`vr'ea Nna nooaess <br />LIiY ZIP GHONE <br />DEAN & SUSAN H0�4�LL 4418 S. 4th Ave. Everett Wa. 258-1273 <br />PHCMIIECT OR OESIGNL�V MAII ADDPE55 CITY ZIP PMONE <br />G[M1EfVAL CONiqAGiOR MAIL pp�RE55 qTY ZIP PNONE UGENSE � <br />SILVER FOX CONSTR. CO. INC. 19624 FALES RD SNOHOMISH 98290 668 5929 <br />MECHANIG/LGONiRACTOR MRILADORE55 CITY 2iP PHONE LICENSE• <br />PWMBING CONTRALiOP MAIL q�ORE55 CITV 21P PHONE UCCNSE i <br />❑ NEW ❑ ADDITION ❑ ALTEHATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN O INOOD STOVEIFIREPLACE INSERi <br />v <br />S 240�.�� <br />OESCRipE 1YORR <br />REROOF RESIDENCE <br />PFO�OSEO USE OF BUIL�ING <br />LEGAL pESGPIPiION OF PROPERiY �SNJW �EI <br />�or_e�ocn_oF <br />�oer,00aess <br />4418 S. $th Ave <br />PLUMB�NG <br />N�• TYPE OF FII(TURE OH <br />WATER CLOSET �TOILET� <br />LAVATORY(WASM BASIN) <br />SHOV�ER <br />KITCMEN SINK 8 DISP. <br />DISHWASNEH <br />LAUNDRViRAY <br />CLOTHESVJASHER <br />WATER HEATER <br />URINAL <br />�RINKING POUNTAIN <br />FLOOR DRAIN <br />VACUUM BREANERS <br />ROOF �RAINS — RAINLEADERS <br />SINK �SERVICE — PAP, ETC) <br />YARD <br />N0. <br />SUBTOTAL <br />PENMIT <br />TOTAL FEE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLAN$ <br />I 4. FIRE PROiECTION SYSTEI <br />5. GRADING <br />G. DRAIIJAGE <br />LLNVIRONMENTALIMPACT <br />B.NEALTH DISTRICT <br />APPLICATION ACC. 8� <br />MD <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />ATTACHFOURLOPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL FROVISInNS OF LAWS AND OADINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO G�VE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LA REGULATING C��N TftUCTION OR THE <br />PERFORAb�G�E OF CONSyRUCTIJp�J//��� <br />SiGNATURF�3F CO iRAC10F OR AyfHowzeo acE�y¢J' nnre <br />FEE <br />� <br />S <br />f <br />REAR YAR� SETI <br />VACANT SITE <br />YES .NO <br />NO. OF DWELLIN <br />MAX.00Q LOAD <br />FIRE SPRINKLER: <br />REOUIRED <br />YES NO <br />BY I APPR. FOR I5: <br />LC <br />-�L� �CI'i�C,X��T <br />MECHANICAL <br />NO. TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFPIuERATION UNIi$ — H.P. EA. <br />BOILERS — HP EA. <br />GAS FIRE� A.C. UNITS — iONNAGE EA. <br />FORCED PIN SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGENOOD <br />AIR HAN�LING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIRLPLACE 8 CHIMNEY <br />FIRLPLACEINSEflT <br />MEAT PUMP <br />SUB TOTAL { <br />PEflM1T = <br />TOTAL FEE f <br />PLAN CMECK NUMBER PLAN CI <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTMER <br />PENALTY <br />TOTAL <br />E <br />SEG �OJ <br />FEE <br />RECEIPT NO. <br />FEE <br />WNEN PROPEHLY VALIDATED pN TMI,$ $PJ��) TNI��Y@l.b.i�Fjly11T (g; <br />if/4 JO J� Q <br />� <br />N <br />YCUR f;EC�IPT.—� <br />T;-';'�fdK Y�U <br />nnoaFss i ii e <br />29�uy83 <br />