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lhe C• vergrcrn � ^O N ST R U�T 10 N� �� <br />CITY OF � <br />everett PERMIT PERMir No: 09311 <br />CITY HP.LL 259�B7A5 <br />[VEFETf, WA 9820t ❑ COMBINATION � BUILDING ❑ MECHANICAL � PLUMBING <br />OWNER MAILAilpRE55 CIiY � 21P PNONE <br />Donald Lannoye 2201 Broadway Everett 98201 252-8622 <br />ARCHRECT OR OESIGNER MAIL ADDRE55 CITY ZIP PHONE <br />GCNERRLGONiRACTOB 41AILA�OflE55 CITY ZIP PHONE UCENSEI <br />Same <br />ME�HANIGALfANiPACtOR MAILAODRE55 CITY ZIP PHONE LICENSlY <br />PWMBIHGGOhiRAGTGB MAILA�DRCSS CIiY ZIP PHONE UCENSE� <br />5 <br />WOPK <br />❑NEW ❑ADDITION ❑AITERATION ❑REPAIR }�DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />\VORK <br />lish aingle <br />) USE OF 6JILDING <br />LEGAL �ESi.RIPiION OF YNUYtHi i(anU�v nc <br />��r Z— 3 eia;K 4�`�F — <br />�' Zo _r9-s <br />��e nooness <br />88HYXSSlidX�9tY�t 21 <br />PLUMBING <br />NO. TYPE OF FIXTU <br />WATER CLOSET (TOILE�1 <br />KITCHEN <br />CLOTHES WASHER <br />WATER HEATEF <br />URINAL <br />DRINKING FOUNL <br />FLGOR DRAIN <br />VACUUM BR61KEi <br />POOF �RAINS — I <br />SINK ISEf?VICE — <br />SIDE YARD SETBACK <br />SIZE OF BL <br />FIRE ZONE <br />STREET <br />NO.OF <br />lv residen <br />I HEREBY CERTIFY THAT I HAVE READ AND E,�(AMINED ThIIS AP- <br />DIVORFTTACHFOUNGOPIES) PLICATION AND KNOW THF SAME TO BE TRUE AND CORRECT. <br />Everett ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPIIED VJITH WHETHER SPECIFIED <br />HER[IN OR NOT. �riE GRANTING O� 4 PERDAIT DOES NOT <br />PRESU ME TO GIVE AUTHORITY TO VIOLATE UR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STP.�E OR LGCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. <br />SIGHAtUryq UF CCNiPACTO AUTNORIZED AGENT OATE <br />�/ � 5�28�81 <br />n ��„a cr.Aat X A/.,..�.✓�� .z..n. � <br />ITEM <br />!. ENVIRONMENTAL CHECK UST <br />2, BUILDING PLANS <br />3. FIRE HVDRANT <br />4. FIRE PROTECTION SVSTEM <br />5. GRADING <br />6. DR�INAGE <br />7. ENVIRONMENTALIMPACTSTATEMEWT <br />B. HEALTH DISTFICT _ <br />A^PUCn"0": :.�> I PI1.Il5 CHECYED f3�' <br />REAR YARD <br />L]YES ❑NO <br />NO.OF DWEL <br />MA%.00C.LC <br />8Y <br />:.ecu �n91$$IL�1Jf[8'i <br />N0. <br />DF <br />AIR <br />UNIi HEA <br />EVAPORA <br />CLOTHLS <br />VENTILAT <br />RANGE H <br />PLAN CHECK <br />M[CHANICAL <br />OTHER <br />PENALTY <br />PE OF EOUIPMENT <br />fS — H.P. EA. <br />� UNITS — H.P. EA <br />EA. <br />UNITS — TONNAGE EA. <br />STEMS—BTL. M <br />—BT.U. M <br />—RTLI. M <br />FAN <br />� UNIT — <br />ACE 8 Ch <br />PLFN CH ECK FE: <br />FEE � NG. <br />VALUATION � PEE _ <br />5 <br />LLB.C. <br />SEC. 503 (al <br />0 <br />TOTAL I I O 0 IO O <br />PERMI7 VALIDATION 1 <br />WHEN PROPERLY VALIDATEG (IN iH15 SPA�E� THIS IS YOilP P�RMCT, C��� �� <br />� . c"� <br />�'--� <br />. i^ IM <br />1 � � <br />.� <br />