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' ,.r <br /> (he Evergreen C(s�J ST R U CTI�N <br /> CITY OF <br /> �r.'v�r�� �'�RM�� PERMIT NO. OS275 <br /> citv Hnu zs�a�as MECHANICAL ❑ PLUMBING <br /> evr:a.Tr.wn s3zoi ❑ COMBINATION ❑ BUILDING � <br />' O'�'MFR MAILADORESS CIiT ZIP P��CNE <br /> Skagit PiM�BM Dlechanical 2110 37th Street 98201 259-0158 <br /> ARCHItGCT OF�ESIGHffI M1IAIL ADDPESS CITV 21P PHONE <br /> GENERALCONTRACTOR MA�LAD�RES& G�Y ZIP PHONE LICENSEr <br />� <br />' MECHANICALCANiRACTOR AIAILAODRESS CIiY ZIP PHONE LICENSEI <br />' Same <br /> PLUMOMG WNiFAQOR 61AIL AGDRESS CITV ZIP PMONE LICENSE� <br /> CtA55 OP\YORK <br /> ❑�JcyJ ❑ADDITION ❑ALTEflATION ❑REPAIR ❑DEMOLITION ❑F�NCE ❑SIGN ❑GARAGE <br />� VALUATION OF YlORK <br />` E <br />� <br /> iDESGRBE KDf�.. <br /> PROPOSED USE OF&UILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />� �ecn�oescaianoiuoFaaoPearru�o�,vee�owaanTrncNFouameiesi PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS ANC ORDINANCES GOVERNI�G THIS <br /> �or e�oc�_oF 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 AVY OTHER STATE OR LOCAL LAW REGULATING <br /> CONST UCTION OR THE P�RMAN E OF CnNSTRUCTION. <br /> dO�A�DRE55 SIGNAiUf� OFCG�l�HACi �O Ui�ORI EUAGENT D/1E <br /> 2110 37th Street X � -� 9 <br /> PLUMBING MECH ICAL <br /> NO,�— TYPE OF FIXTURE OR ITEM FEE N0. TY?E OF EQUIPMENT FEE <br />�� 1Vf�iER CLOS'iT ITOILET) AIR COND.UNITS—H.F.EA. <br /> BATHTUB Rf.FRIGERATION UNITS—H.P.EA _ <br /> Ll�VATORY(WASH BASW) BORERS—H.P.EA. <br /> SHOYJER 1 GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 6 DISP. FOFCEG AIR SYSTENS—B.i.U. M EA. <br /> UISHWASHER WALL HEArERS—�.T.U. M <br /> LHUNDRY TR�Y UNIT HEATERS—B.T.U. M 1 Z OO <br /> CLOTHES WASHEF EVAPORATIVE CCOLERS <br /> WATER HEATER CLOiHES DRYEFS <br /> UHINFL VENTMTION FAN <br /> ORINKMG FOUNTAIN RANGE HOOD _ <br /> FLOOR DFAIN AIR HANDLING UIJIT— QF.M. <br /> VqCUUM Bf�EAKERS STOVE <br /> ROOF DRAMS—RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK�SERVICE—BAR,ETC.) 6 GdS CUtlE:tS lg �� <br /> SUB TOTAI. SUB TOTAL S <br /> PEflMiT S PEPMIT S <br /> TOTALFEE S TOTAL FEE S 3 <br /> SIDE YARD SETBACK STREET SETDACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT I.J. <br /> USE ZJNE L07 AREA VACANT SIfE PEES VALUATIDN FEE <br /> ❑YES ❑NO _ <br /> TYPE OF CONST. � OCCUPANCY GROUP N0.UF DWELLING UNITS I <br /> BUILDING g � <br /> S2E OP�LDG. NO.OF STORIES MWi OGQ LOAD I <br /> PLUMBING �� <br /> FIqEZONE BASEMENT REOUIREDKLERS MECHANICAL BS OO ! <br /> ❑YES ❑NO <br /> APPROYALS BV OATE aTHER , <br /> 1. ENVIRONMENTAL CHECK LIST PENAL7Y U.B.C. <br /> . SEC.303(a) --�� <br /> 2. BUILDING PLANS <br /> TOTAL 35 00 � <br /> 3. FIRE HYDRANT <br /> a. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDAtED IIN THIS SPACE)THIS iS 70UR PERMIT <br /> S. GRAOING 7685 $ 035. 00 -- .� <br /> 6. DRAINAGE I` ' <br /> 7. ENVIRONMENTAL IMPACT STATEMENT N 1 <br /> a Hen�TH oisrr�icT `i�. ` !) 12 R�C F I PT p <br /> APPLICATION ACC.BY PLFNS CHECKED BY APPR.FOR ISSUANCE BY _ � t � <br /> . . ,,>.Nr., Yo u <br /> , <br /> � 2 SEP $O <br /> ADDRESS FILE i <br /> r„ <br />