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rhe Evergrcen C�� ST R U CT I O N <br />aTv or <br />everett PERMIT pERMIT NO. 09117 <br />CITV HALL 2E9�d745 <br />eveaett. wn sezoi ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OWNER MAILAf�DRC55 CIiY ZIP PIIJNE <br />Hallauer, John 2122 Virginia Everett 98201 252-6455 <br />ARCIIRECiORDE5IGN[R MAILADDRE55 CIiY ZiP PN�NE <br />GUI[RAICONIii/GiOH MAILADDPE55 CI1Y ZIP PHONE LICAJSEI <br />Owner <br />MLCHAMCAIGONiRaGtOR MAILN�OR[55 LRY Z'�P PHONE UCRJSLr <br />PWMBiNGCANiRRC10R �a�RAD�RE55 GITY ZiF PHONE LICErvSE� <br />WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑�7EPAIR ❑DEMOLITION ❑FENCE ❑SIGN OGARAGE <br />E <br />Wood stove <br />PR04'OSED US[ OF �UILDING <br />Sin91e family residence <br />LECAL oESCRIPiION oP rNovENTY �SMow o[tow on <br />ior o�ocK_oF <br />2122 Vir� <br />PLUN BING <br />NO. <br />WAl[fl CI <br />ai1TF���o <br />nia, Everett <br />WASHEF <br />FIXTURE OR ITEM <br />�RAIN <br />M BREAKERS <br />7RAIN5 — RAINLEADEFS <br />FRVICP — RAP. ETCJ <br />TOTAL <br />YARD SETI3ALK I STRLET SETBACK <br />T: PE OF CON:L OCCUPANCV GP� <br />SIZE OF BID�. NO OF STORIES <br />ZONE <br />1. ENVIRONMENTALCHECKLIST <br />2. BUILDINGFLl�NS <br />3. FIRE HYDRANT <br />4. FIfiE PR0IECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTALIMPACTSTATEMENT <br />8. HEALiH DISTRIGT <br />APPLICATIOIJ ACC �V PLANS CHECKE� BY <br />I HEREBY CERTIFY THAT I HAVE REAC AND EXAMINED THIS AP� <br />coPiEsi PLICATION AND KNOW THE SAME TO BE TRUt AND CORREGT. <br />ALL PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK 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 A�Y OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THF PERFORMANCE OF CONSTRUCTION. <br />scr+niun�o� orviancruiv�oq.aurrp��j neEur onr� <br />��� J� /,(� /il�..s � 4/13/81 <br />N0. TYPE OF EL <br />AIp GOND. UNI7S — H P_ I <br />o[m�n[nnTV11J I!1JIT5 — <br />GAS FIRED AC. UNITS — <br />FORCEO AIR SVSiEMS — <br />WALL HEATERS — � i.U. <br />UNIT HEATERS — B T.U. <br />EVAPORATNECOOLERS <br />CLO7HES DRYERS <br />VENTIIATION FAN <br />RANGEH00� <br />AIR HANDLING UNIT — <br />MEIAL P <br />RGAfl YARD SET�ACK PLAN CHECK <br />VACANT SITE <br />CiYES ❑NO <br />N0. OP DWRLING UNITS <br />BY <br />APPfi FCR iSSUANCE OY <br />�C <br />�UILDING <br />PLUMOING <br />MCCHANICAL <br />OTHHR <br />PENALTV <br />TOTAL <br />FEE <br />EA <br />M <br />M <br />TOTAL FEE S� � <br />PLN� CN[CK FE[ <br />FE[ I NECEIPT NO. <br />S <br />U B.C. <br />SF.C. 30� (a) <br />. _...._ __._.__.. <br />\YH[N PROPflRLY VhLIDATED QN THIS SPACE) THIS 15 YOUR PCRMIT <br />14 I 50 <br />14150 <br />��..�j <br />� � � l' � '�� � �. �1 ��' -- [_'7 <br />� <br />� <br />,, i �'T <br />; <br />