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�hcEvcrgrecn � CO�ySTRUCTION �- ���� <br />everett PERMIT PERMIT N0. 07596 <br />CITY HALL 259�8745 <br />EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OYI.YtP MMl AODRE55 CIiY ZIP PHONE <br />Victor Bolstad 8611 Xavier Way 98204 353-7204 <br />AqCMITGCT ( P �ESiGNER MRIL RDDRESS CITY ZiP PIIONE <br />GENERALCCNiRAL10P IdRILADOREiS CITY ZIP PMONE lIC[NSEI <br />Self <br />kECNAWGALCUNTFACiLN MA�LADORF.:S CITY ZiP PMONE IICEN5E1 <br />FLUMBINGCONTPPCiOR MAII ApDRCS GiY 21P PMON[ LICENSE � <br />WOHK <br />❑NEW C�ADDITION ❑ALTERA110N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VA�UATION OF WORK <br />S .LI�00.00 <br />DESCRIOE WORN <br />30x10 Deck 6 Cover <br />LEGAL OESCPIPiION OF PROPEPTY ISMOW BE.OW OR ATTALM FOUR CAvi <br />or lg Bi��_�F Beverly View Lands <br />Division No. 2 <br />8611 Xavier <br />PLUMBINO <br />ROOF <br />SIDE YARD <br />ZONE <br />TYPE OF <br />TRAV <br />0 <br />� <br />Everett <br />FIXTURE <br />STREET SETBAGK REAF Y <br />LOTAREA V�CAN' <br />❑YES <br />OCCUPANCY GROUP NO.CF <br />NO. OF STORIES MA%. O <br />t. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLl�1l5 <br />3. FIRE HYDRANT <br />4. FIPL PROTEf.T10N SYSTEM <br />5. GRADING _ <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT S"iATEAfENT <br />B. HEALT4 DISTRICT _ <br />APPLICATION ACC. BY PLANS CHECKEO BY <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE THUE AND CORRECT. <br />ALL PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OH NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUThIORITY TO VIOLATE OR CANCELTHE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATIN : <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SiGNR1UHEOFCONTRFCiORORAUi�iORIZEDAGENi DNTE <br />x „ r .� ' � 5-�6-eo _ <br />MECHANICAL <br />N0. TYPE OF E�UIPMENT FEE <br />AIR COND UNITS — N P EA <br />RFFRIf:FRATION IINITS — H.R EP <br />tivaena — nr. en. <br />GAS FIRED AC. UNITS — TONNAGE EA. <br />FORCED AIP SYSTEMS — B TU. tA EA. <br />WALL HLAlERS — 8 T.U. M <br />UNIT H[AlERS — 0 T.LL �� <br />GVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />l7ANGE HOOD <br />AIR NANDLING UNIi — C.F.M. _ <br />STOVE <br />METAL FlREPLACE 8 CHIMNE� <br />SUB TOTAL S <br />PERMIT S <br />70TAL FEE : <br />SET�ACK PLAN CHECK NUMBER PLAN CHECKFEE <br />FEE I RECEIPT NU. <br />C.NO <br />D\YELLING UNITS <br />BUILDING <br />x. ! OAD <br />PLUMBING <br />RINKLERS MECHANICAL <br />ED <br />❑NO <br />DATE OTHER <br />PENALTY <br />TOTAL <br />APPfl.FOBISSUANCE BV <br />FEES VALVAIIun rcc <br />$1��0�.�0 1� �� <br />U.BL. <br />SEC.303�a) <br />u <br />1� 11 <br />T VALIDATION <br />PROPERLV VALIDAIED (W THIS 5?A'EFT� IS IS' j1l�i iEqMlj O �� '• <br />L L 9 I � U Q Q <br />� <br />i.i�i <br />YOUR RECEIP o <br />-ryar!K You <br />