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`'"E"�gY`oF C�N�TR�CTION <br />,- <br />everett PEf1�IT PERMIT NO.O$54Q <br />CITY HALL 259�8I45 <br />EVERETf. WA 9�20i ❑ COMBINATION ❑ BUILDING �] MECHANICAL ❑ pLUMBING <br />01VNER MML ADURE55 QTY ZIP PHONE <br />Michael R. Cross P. O. Box 865 Everett 98206 252-0204 <br />ARCNITEGT OP �ESIGNEN MAIL ADpqE55 CITY ZIP PHONE <br />GENERALGONiRACTOR MnILAD�RE55 QTY IIF PHfNE LICENSEI <br />IdEGHFNICAI CONTRACTOR h1AIL ADpRESS GIiY ZIP PMONE LICENSE / <br />PWAIBINGCONTRACTOR MAI�AOOPE55 qTY IIP PHONE LILENSE• <br />C1A550F WORK - � <br />❑NEW ❑ADDITION �AL7ERA710N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VF�UATION OP WORK <br />E <br />DESCRIBE WOPK <br />Wood heater and revent existing gas furnace <br />PRO?OSED USE OF BWLDING <br />Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />�ec.��oescR�PriowoFar�Pearv�sHowae�oweaanncNFovacoaies� PLICATION AND KNOW THE SAME TO BE TfiUE AND CORRECT. <br />ALL PROVISIONS OF L4WS AND ORDINANCES GOVERNING THIS <br />�or aice�oF TYPE OF WORK WILL BE ^OMPL W <br />JOB F�DFESS <br />1209 - 35th, Everett <br />PLUMBING <br />NO. TYPE OF FIXTUHE OR ITEM FEE <br />WA7Efl CLOSEr ROILE7) <br />BATHTUB <br />LAVi lu?'f QNASH BASIN) <br />SHG VER <br />KITCV�EN SWK 8 OISP. <br />DISH\'.ASHEfl <br />LAUNDRY LRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FO:INTAIN <br />nvvr �nNInJ — nqlryLtAUtF <br />SINK (SERVICE — BAH, ETC.) <br />SUB TC <br />PENMII <br />TOTAL <br />SIDE YAR� SE7BhCK STREET 51 <br />USEZONE LOTAREA <br />TlPE OFCONST. OCCUPAN <br />SIZE OF BLDG. No. oF ST <br />FIRE <br />BASEMENT <br />I. ENVIRONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />3. FIRE HVDHANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMEN7Al. IMPACT STATEMENT <br />B. NEALTH DISTRIC7 <br />APPLICATION ACC. BY PLANS CHECKED BY <br />REAR YAqD SETBACK <br />❑YES ❑NO <br />N0. OF �WEL <br />APPR.FORISSUANCE BY <br />IED ITH WHETHER SPECIFIED <br />H�REIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCE� THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR T:1E PERFOR��ANCF OF CONSTRUCTION. <br />SiGn'nTURE OF OUTPA�f q C�i AU OFIZED .GEN� OATE <br />X���u✓` �,� ��`'.v�[__ 11/6/80 <br />ME:HANICAL <br />TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />VILC,IJ � t1.Y. CN. <br />GAS FIREU A.C. UNITS — <br />FORCED AIR SYSTEldS — <br />NJA�L HEAIERS — 6.T.U. <br />UNIT HEA7ER5 — BS.U. <br />EVAPORA', IVE COOIERS <br />CLOTHES DRYEflS <br />VENTI:ATIO�� FAN <br />RANGE HOOD <br />AIR HANDLMG UNIT — <br />METAL <br />NUMBER <br />3UILDING <br />PIUMBING <br />MECHANICAL <br />PENALTv <br />M <br />FEE <br />VALUATION <br />$ <br />U.B.C. <br />SEC. 303 (a) <br />FEE <br />RECEIPT NO. <br />15 I50 <br />1 <br />PROPERLY VALIDATED pN THIS SPACE) THIS IS YOUR PERMIT <br />ot9i �015.50—�j <br />� <br />� <br />� ;;, I::I.E�FTo <br />' � � �! ��1: U <br />, ♦ <br />ADDRESS FILE � S'���� oO <br />