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. , <br /> theEvergreen ^ C�STRUCTION r �� <br /> CITY OF <br /> everett P�RMIT PERMIT NO. 07567 <br /> cin HA��LE7'BIAS <br /> EVERETf,WA 98201 ❑ COMBINATION � BUILDINCi ❑ MECHANICAL PLUMBING <br /> OWNEP MnRRODRE55 GTY ZIP PMONE <br /> Rohert C T�" ' ^^^ > > 2'� Rucker Everett 9820� 252-1247 <br /> APCMREGT OR OESIGNER I.IAIL NODPE55 CITY ZIP PNONE <br /> GENCRAI fANiMCi01i N�IL ADDPE55 CILY 21P PMONE LICEYSE� <br /> MECM�NiCNLCANTRACIOR M�ILr1DDRE55 CITY ZIP VMONE IICENSE� <br /> PLUM9INGCANTRACTOR MRILAOORESS CITV ZiP PHDNE IICENSE� <br /> CUSS OF WORN <br /> �EW ❑ADDITION ❑ALTERATION ❑R[PAIR ❑DEMOLITION ❑FENCE ❑SIGN GARAGE <br /> V�W�TION OF WORK <br /> t 7 500.�0 <br /> DESCRIBE WORK <br /> New ara e 24x30 <br /> PRO'OSED USE OF BUI:OING <br /> Gdi'd 0 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> LEGQOESCNIPTIONOFPROPERTV�SHOWBEtOWORATTACHFOURCA�IES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ioT 5&66a. t O� 7 Blk 222 Hel ht5 Add TYPE OF N'�RK WILL BE COMPL�ED W�TH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> S eZ' ldt Z'EC VOl 3 Of 1dtS PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCEL?NEPRO� , <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINC <br /> CONSTRUCTION R THE PERFORMANCE OF CONSTRUCTION. <br /> 40 R0C SIIO CO. sicN r�;R oaoa�urN r+2joaceNt DRIE <br /> JOB FUDRE55 / ��/� �� <br /> �. �I-T/ <br /> PLUMSINO MECNANICAI � <br /> N0. TVPE OF FIXTURE OR ITEM FEE N0. TYPE UF EOUIPMENT FEE _ <br /> WATER CLOSET(TOIL AIA CAND.UNITS-H.P.EA. �� <br /> BATHTUB REFRIGERATION UNITS-H.P.EA <br /> UVATORY ASH BASIN BOLLEFS-H.P.EA . <br /> SMOWER GAS FIRFD AC.UNITS-TONNAGE EA. <br /> KITCHEN SINK 6 DISP. FORCF.D A'F SYSTEMS-B T.U. A�EA. _ <br /> WALL NEA1E95-BT.U. M . . <br /> � DISMWNSHER � <br /> UUNDRV TRAY UNIT HEATERS -B T.0 M <br /> CLOTMES WASHER EVAPORATNE fA�LERS � <br /> WATER HFATER CLOTHES DRYERS <br /> UPINAL VENTIIATION FAN <br /> DRINKING FOUNTAIN IiANGE HOOD , <br /> FLOOR DMIN AIR HANDLING UNIT- C.F M. � <br /> VACUUM BREAKERS STOVE ; <br /> ROOF DMINS-NJNLEADER.; MEiAL FiREPIACE 8 CNIMNEY . <br /> � <br /> SINK(SERVICE-NAN.ETC.) �. <br /> SU!TOTAL SUS TOTIIL f <br /> PEIIMIT f PERMIT f <br /> TOT�L FEE f TOTA:FEE � <br /> � SIDE YARD SFT W1�K STREFT SETAACK REAR YARD SETBACK P�AN CHECK NUMBER PLAN CHECK FEE <br /> � � <br /> 7567 FEE ZZ 00 RECEIPTNO. <br /> USE ZONE LOT AREA OY SNT C�10 FEES V�LUATION <br /> TYPE OF CONST. OCCUPANGV GROUP NO.OF DWELLING UNITS <br /> V�N M��. ����- BUILDING E�]SQO.00 44 OO <br /> SIZE OF BLDG. NO.Of STOPIES MAX.O'x.LOAD <br /> 24'x30' S. ----- PLUM�ING <br /> FIRE ZONE BASEMENT qEOUIRED KLERS MECMANICAL <br /> 3 ------ uves o <br /> AMIIOVAIt !Y DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST pENq�ry U B.C. <br /> SEC.303(a) <br /> 2. BUILDI�:3PUNS TOTAL 44 �� <br /> 3. FIRE HYDMNT <br /> �. FIRE PROTECTION SYSTEM �EIIMIT V1llIDAT7M1 <br /> WHEN PROPERLY VALIDATED(IN TNIS SPACE)THIS IS YOU/�R PER`MIT 1 <br /> 5. GMDING Z � 9 O � U �Y.G O �� 1 r <br /> 6. DRAINRGE � � <br /> � <br /> 7. ENVIRONMENTAL IMPACT STATEMENT <br /> B. HEALTHDISTflICT YOUR RECEIPT o <br /> APPLICATION ACC.BY PIANS CHECKED BY APPR.FOR ISSUANCE BY ��4�hj►�..�ny�, _ � <br /> � ��n t� <br /> V.C. , '' , . ' � <br /> I t � I��Y g� <br /> ADDRESS FILE _:__._� ' - <br />