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dieEvergreen �� %���������ION ' , <br />GTY OF � <br />ev�ret� PER�IIIT pERMIT N0. OS ;4s <br />CIT1' HALL 259�87J5 <br />EVEFETf.VJA 98207 ❑ COMBINATION C� BUILDING ❑ MECHANICAL ❑ �LUMBINC� <br />OWNEfl AIhILAppRE55 UiY Z'P PHONE <br />�pn *p�'--' Box 958 Everett 98206 259-9151 <br />AfiCH17ECIOPDE5IGNER MAILAOOflE55 CRY 211' PMO�IE <br />GENERALC�MAACIOR MFILA��PESS CITY ZIP PHONE IICEN5E1 <br />i7ewland Const Co. <br />MECNANICALCANTRACTOR MAILAD�PE55 LIiV ZIP PHUN[ IICENSE� <br />PLUUOING LONTRACiOP MAIL i��FE55 QTY ZIP PNONE UCENSE 1 <br />❑NEIV ❑ADDITION ❑ALTERATION ❑RePAIR �j-I(jpEMOLITION ❑FLNi.[ ❑SIGN ❑GARAGF. <br />f <br />�ESCRIBE WORK <br />Demolish Single Family Residence <br />PFOPOSEJ V5=0F BUILDING <br />single famiiy residence <br />LEG/L DEtlC1�IPTION Of PFOPERTY �SHOW BELOW OR ATTACN FGUR LOPIFS� <br />�or 53-S��a 3K 72 oF Everett Div. G <br />szxxxftxxx�x <br />�- <br />PLUMBING <br />NO. TYPE <br />YJAIFR ClOSE! (T <br />BAT 1TUB <br />LAVf,TOriY (N'FSH <br />SHOWEFl <br />KITCIIEN SINK 81 <br />OI,iF WASHEH <br />LAUNf1RV TRAY <br />CL01'HES WASHEI <br />WATI:R hiEATFR <br />URINAL <br />DRINKING FOUNI <br />FLOOR DRAIN <br />VACUU�d BREAKE <br />flOOF DPAINS— <br />GINH ;SFRVIfF — <br />SIDE YARD SE7 <br />USE ZONE <br />TYPE OF CONS <br />SIZE OF BLDG. <br />FItiE 20NE <br />1213 21st Street <br />OR ITEM <br />STREETSETBACK <br />LOT AREA <br />OCCUPANCY GRC <br />1. ENVIRONMEI:7ALCHECKLIST <br />2. BUILDING PIANS <br />3. FIfiE HYDFANT <br />4. PIRE PROTECTION SYSTEld <br />5. GRhDING <br />6. URAINAGE <br />!. tNVIRpNMENiAL IMPACT $TATEMENT <br />B. HEALTH OLiiRICT <br />APPLICATION ACi;. BY T f:S CHECKED BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION ANC KNOW THF SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COh".PLI[D WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRHNTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TOylOLeTE OR CANCELTHE PRO� <br />VISIONS OF ANY O�.T'''l���'''1��✓ER STAT� OR LCiCAL LAW REGULATING <br />CONSTRI�T�OR �ERF MANC OF CONSTRUCTION. <br />SIGNATURE OF COMH� i0fi ❑iHORI AUENi OATE <br />5/26/80 <br />X .��_ G <br />NQ. <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — HP. i <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. U�11TS — WNN <br />FORCED AIR SYSTEh'S — B T.U. <br />WALL HEATERS — 0 T.U. <br />uNIT HFATERS — 0 T.U. <br />AIR HA�:ULING UNIT — <br />REAR YARD SETBACK PLAN CHECKI <br />VACANT SITE <br />❑YES i7N0 <br />NO. OF DWELLING UNITS <br />BUILDING <br />MA%,OCC.LOAD <br />PLUMBING <br />fIRE SPRINKLERS <br />REOUIRED MECHANICAL <br />❑YES ❑NO <br />BV DATE OTHER <br />PENALTY <br />hPPF. FOR 135UANC[ �Y <br />M <br />M <br />FIREPLACE S CHIMNEY <br />SUB 70TAL S <br />PERMIT S <br />TOTALFEE 1 � <br />UMBER PLAt: CHECK FEE <br />FEE P,ECEIPT NO. <br />FEES VALUA710N FEE <br />b <br />U.B'�. <br />SEC. 3�7 �a) <br />PROPERLV Vh�I�ATED (IN THIS SPA^E) THIS IS YOUR PERMIT <br />8337 �aoo.00--� <br />� <br />M <br />,, i,^, R:�:CGIP?o <br />_ �.•.�.li: �'C7U <br />"w <br />� <br />