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1 <br />theEvergreen ,' � �7NSTRUCTION � �� <br />CITY OF <br />everet� PERMIT PERMIT NO. OH463 <br />CITY HALL 259�8745 <br />EVERETT. WA 98201 ❑ COMBiNATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OW��EP � MAILAODRESS GITY ZIP PHOIIE <br />EDGAR A ROGERS 2502 - 19th, Ev�rett 98201 259-5274 <br />ARCHRECtORGE516NER �AILA��RE55 CIT1' ZIP PMONE <br />GENERAL CONTFACiOfl MnIL ADORESS GITY ZIP PNONE LICENSE � <br />Owner — <br />MECMANICAL CONTRACiOR MAII ADORE55 QTY 21P PNONE LICENSC I <br />PLUMBINGGONTRACTOP MAIIPDDPESS CIiY ZIP PHOYE LICENSE� <br />CLASS OF WORH <br />❑NEW ❑hvU1TION ❑hLTERAT10N OREPAIR ❑DEMOLITION ❑FE4CE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />E - <br />DESCFiBE WOFK <br />stove <br />PFOPOSED USE OF BUILDI4G <br />Residence <br />�EGAL OESGF�Fr10N OF PPOPERTY ISHOW <br />�o. 1� 2 e�ocK_oF Re <br />D� ADDRE55 <br />2502 - 19th S <br />PLUMBING <br />N0. TYPE OF <br />WATER CLOSET (TOILE <br />BATHTUB <br />LAVATORY�WASH BAS <br />SHOIYER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />Dfll'rtiING FOUNTAIN <br />FLOOfl DRAIN <br />ROOF DRAINS — <br />e�niv �ccovirr — <br />SIUE YAR� SETBACK STREET SETN <br />USE 20NE LO7 AREA <br />TYPE OFCONST. OCCUPANCV <br />SIZE OF BLDG. NO. OF STOF <br />FIRE ZONE BASEMENT <br />APPpOYALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUIIDING PLANS <br />3. FIRE HYDRqNT <br />4. FIRE PFl�TECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONAIENTPL IMPACT STATEMENT <br />B. HEAL7H DISTRICT <br />COPIES� <br />REAR YAR7 SETO, <br />VACANT SITL <br />❑YES L�NO <br />NO.OF DWELLWc <br />UAX.00C.LOAD <br />FIRE SPRINKLER: <br />FEOUIRED <br />LlYES ❑NO <br />BY DATE <br />APPUCATION ACC. BY � PL4N5 CHECKED BV I APPR. FOF ISSUANCE BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS UF LAWS AND ORDINANC[S GOVERN{NG THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETH[R �PECIF�tD <br />HEREIN OR NOT. THE uRANTING OF A PERMIT UOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE UR CANCL�L THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW �iEGULATING <br />CONSTRUCTION Of; THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAtURE OF GOHTRACTOR O�1 AUTN081ZED AGENT DATE <br />X �',f�r ��:.' �' pi ,�.'.�� to�2l�an— <br />MECHANICAL <br />AIR WND. IJNITS — H.P. EA. <br />P.EFRIGERATION UNITS — H.F. EA <br />BOILERS — N.P. EA. <br />GAS FIRED A.G UNITS — TONNAGE EA. <br />FOPCED AIR SYSTEMS — 9.T.U. � <br />WALL HEATEflS — BS.LL � <br />uNIT HEATERS -- �.T.U. � <br />AIR <br />METAL <br />CHECK <br />�UILDING <br />FLUMD!NG <br />MECHANICAL <br />OTHER <br />PENALTY <br />GP.M. <br />PLAN <br />FEE <br />VALUATION <br />3 <br />U.B.C. <br />SEC. 303 (a) <br />r�� <br />RECEIPT NO. <br />ree <br />PROPERLY VALI�AS�ED (IN THIS SPACE) 7HIS IS YOUR PE'1MIT <br />939 <br />7Fi7 <br />M <br />� �007.50=� <br />� <br />• . ; � � � n � , : C l _ � I 1 � <br />_ . . . ... ., :. U <br />"4 <br />� <br />