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dteF�CiveOF � �NSYRUCTiON � � ' � <br />everett PERMIT p�RMIT NO. 06737 <br />CITV HALL 259�d7a5 <br />eveaelT wn 9ezo� ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEH MniLADOP[SS ❑tY ZIP PHOtlE <br />Robert G. Miller 7024 Colby 98203 355-9099 <br />nRCNI1EGT OR �ESIGNER MAIL ADOFE55 CiiY LP PHONE <br />GENERAICONTRACTOF MAILADDRE55 CIiY 21P PHONE UCENSE� <br />Same <br />lAECHANICALCONiRACTOR b�A�LPDOPES$ QiY ZIP PHONE �ICENSEI <br />PLUMPMG CONTRPCtOR 6�aIL ADDRE55 CrtY ZIP PHONE LICEtlSE � <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑AL7ERATION ❑REPAIR [�EMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORN <br />$ <br />DESCRIBE wORN <br />demolish sinale familv res;r7anra <br />vaovoseo use oF ouaoiNc <br />8-9 o„V„ 1 <br />011/DDRF55 <br />88�X 2520 19th Street <br />PLUMBING <br />N0. TYPE OF FI%TURE OF <br />WATER C�OSEi IiOILET) <br />Bn7HTU� <br />LAVATORY (WASH BASIN� <br />SHOWEF� <br />KITCHEN SINK & DISP. <br />UISHWASHER <br />LAUNDRYTRAV <br />CLOTHESlVASHER <br />WA1ER HEATEfl <br />URINAL <br />SINK <br />SIDE YARD SETBACri <br />USE ZONE <br />TVPE OF COIJST. <br />SIZE OF BLDG. <br />o — nirv��n�ono <br />E — �AR.ETCJ <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />STRFCiSGiDACK <br />LOT AREA <br />OCCUPANCY GR( <br />90. OF STORIES <br />BASEh9ENT <br />APPNOVALS <br />1. ENVIRONMEIJTAL CHECK LISi <br />2. �U�LDING PLANS <br />3 FlHEHYDRANT <br />4. FIR[ PROTECiION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. [MVIRONMLNTAL I�IPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICFTION ACC. BY PLANS CHECNED BY <br />RLAR YARD SRf <br />VACANT SITE <br />L7YE5 ❑NO <br />NO. OF DWELLIN <br />MAX.OGQ LOAD <br />FIRE SPRINKLER: <br />REQUIRED <br />IIYES i1N0 <br />BY DATE <br />AFPR FOR ISSUANCE BV <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS .4P- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL B[ COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRAN?ING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />Cf>WSTAI�CTION OR THE PERFORMANCE OF CONSTRUCTION. <br />�e^ra�nt�l.corrnr,crono�nun�oaizeonctr� onre <br />X%�-��c�j�.��P�s,,cJ 9/24/79 <br />MECHANICAL <br />NO. TYPE OF E�UIP� <br />AIR CONf7. UNITS — HP. EA. <br />flEFRIGCf7ATION UNITS — H.P. I <br />�OILERS — HP. EA. <br />ona rinev n.�. �niro -- �vnrv. <br />FORCED AIR SYSTEMS — B7.U. <br />PJALL HEATERS — B 1L. <br />UNIT NEATERS — B.T.U. <br />CLOTHES DRVEPS <br />RANGEHOOD <br />SiOVE <br />FEE <br />M EA <br />A1 <br />SUBTO7AL E <br />FEHMIT E <br />TOTALFEE 5 <br />NBEF PLAN CHECK FLE <br />FEE RECEIPT. NO <br />FEES VALUATION FEE <br />BUILDING b 00 00 <br />PWMBING <br />MECHANICAL <br />OTHER <br />PENALTV U B C. <br />SEC.303�a) <br />TOTAL OO OO <br />PERMIT VALIDATION <br />V!H[N PROPLRI.Y VALI�ATEO pN THIS SPACF) THIS IS YOUR PERh11T <br />2655 s000.00�,�� <br />M <br />. � <br />YC�UR RECEiPT� <br />THANK YOU � <br />2 4 s�r 7 9 <br />