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the Evergreen <br /> ��rtoF C _ )IVSTRIlCTION , <br /> everett ��RMIY PERMIT ;�o: � 97� � <br /> 259 - 8745 - <br /> ❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL fl PLUMBING ❑ SIGN �� <br /> OWNEF MARApDRESS CITY 21P PHONE <br /> Glen and R�&!K% Evelyn Chapman 11919 Alaxander Rd. Everett, WA 98204 353-9437 <br /> 4RCHIiECi OR�ESiGNER MAIL ADORESS CITY ZiV PMONE i <br /> GF.NERALCOYTdACTOq L�NIADORE55 �rtY ZIP PHONE LICENSEx <br /> owner <br /> RfECM/KICALCONTR�CTOR MAILAODRESS CITY ZIP PHONE LICENSEx <br /> PLUMBINGCONTRACTOR MAILAD�RE55 CITY ZIP PIIONE LICENSE� I <br /> CLASS OF WORN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION f�] qEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION � <br /> VAWfTION OF WOPX � <br /> S 2��.�0 <br /> oEscniae woaK <br /> Repair Rear Porch . <br /> HEATSOURCE � <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> PROPUSEOUSEOfBUILDING — � <br /> Single family residence I HERE3Y CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATIOM AND KNOW THE SAME TO BE TRUE AND i <br /> LEGfLDESCRIPT10NOFPROPERTY�5HOW8EL01Y0RATTACHFOIIRCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_OLOCK _ OF GOVERNWG THIS TYPE OF WOPR WILL BE COMPLIED WITH ' <br /> � WHETHER SPECIFIED HEREIN QFi NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GI`�E AUTHOR�TY "i0 <br /> — VIOLATE OR CANCEL THE PROVISIONS OF ANY UTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE P�RFORMANCE OF CONSTRUCTION. <br /> JOBAODBE55 SIGNAj�AEOFCON �Cf(JIy�UT qi2 �AGENT.OROWNER 04 E <br /> 1309 39th St. X • � �, �� � / �p� � <br /> � „Jf�F-��Yrn� � �� i1 � <br /> PLUMBING ECHANIqAL � <br /> l <br /> NO. TYPE OF FIXTUflE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE .� <br /> WATER CLOSET�TOILET� A�C—ArMNDLG UNITS—H P. <br /> BATHTUB REFRIGERATION UNITS—H P.EA � <br /> LAVATORV�WASH BASIN� BOILERS—BS.UIH.P � <br /> SHOWER GASFIREDAL UNITS—B.T.0 � <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T U �d EA. <br /> DISHWASHER WALLHEATERS—B.TU. M i <br /> LAUNDRY TRAY UNIT HEATERS—�.TL. h1 <br /> CLOTHES WASHER EVAPORATIVE COOLEflS � <br /> URINAL CLOiHES DFVERS <br /> �RINHING FOUNTAIN VENTILATION FAN �� <br /> FLOOR�RAIN qnNGE HOOD 'i. <br /> L3ACKFLOWPREVENTEFS WATERHEATER � � <br /> ROOF DRAINS—RAINLEA�ERS WOOD STOVE V <br /> SMK(SFRVIC�—BAR,ETC.� METAL FIREPLACE 8 CHIMNEV � <br /> FIREPLACEINSEFT <br /> HEAT PUh1P <br /> GAS PIPING <br /> E%HAUiT FAN 11d <br /> _ ( <br /> SUB'fOTAL $ SUB TOTAL <br /> PERMIT 5 PERMIT <br /> TOTAL FEE S TOTAL FEE <br /> F�orvT SEToaCN aEnn SETonCk 5mE SET9nCK PLAN CNECK NUMBER FEE RECEIPT NO. <br /> USE ZONE LOT AREA <br /> vncnNrsire FEES � VALUATION FEE <br /> ❑YES l INO <br /> TYPEOFCONST OCCUPFNCYGROUP NOOFDWELIINGUNIiS BUILDING SZOO.00 ZS OO <br /> PLUMBING <br /> SIZE OF BLDG. NO OF STORIES MA% OCC LOAO <br /> MECHANICAL � <br /> INVESTIGATION FEE Sec.304(e) I <br /> FIPE SPRINKLERS REOUIPED ❑VES ❑NO <br /> STATFBUILDINGSURCHARGE 3 SO � <br /> STATEENEFGVSURCHARGE <br /> nfFLICAT101J�CC t3`: PLANS CIIECNED[1T APPR FOR ISSUANCE OY ' <br /> DHIVEWAY NERMIT <br /> S.H. TOTAL 16 50 � <br /> PEf7M1T VALIDATION I ; � <br /> WI-IEN PROPERLV VALIDATED�IN THiS SPACE)THI515 VOUR PERh11T ' <br /> M �,,� <br /> T— t� <br /> L� <br /> L7� <br /> � I <br /> F ,, _ ° <br /> �_ ' <br />