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rGr E�'urv o� �J� � 6!� � V�� I'O.i 1°� <br />e�erett ���,a,l� PERMIT N0. 1�4Q 3 <br />CITY HALL 259�87n5 <br />rvenerl.v�a ����, ❑ COMBINATION QtBUILDIN(; ❑ MECHANICAL ❑ PLUMBING <br />�::I+fJi f.INLAUJNESS GILY ZIV 4110NF <br />Donald Gilbert 10222 9th Avenue West Everett 98204 355-1279 <br />...r.;nicrono[s:�ut.r+ ina�nooness citv zia r��one � <br />,_,:i�vLL G01l1iVAC1pP h1AIL FD'JRE55 GIiY ZIP Vf�ONE LiGP!". <br />Same <br />� auce, <br />. _!..'i1rt:G GONiRAGiOR <br />CIiV ZiP PHONE LIC[I:'.;i <br />GITV ZIV PHONF LIGH,b��.. • <br />. , .,'.': OF WORK <br />I_]NEW I_�S%SODITION ❑AL7ERATION ❑RFPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />..��10.110H OF I:ORK <br />, rJ�Q��.�Q <br />. f':[�llqLV:OFH <br />Add to existing residence <br />-� O;LDl15EOFBUIIDING <br />single family residence <br />.^ l �ESURIP�ION OF PRC^CP i Y 1-`+I IO':: f1ZLGVl CP hT i 4CH FpUR CUPIES� <br />16 o��K_oF Olivia Park Div. 1 <br />Ir LJRE55 <br />10222 9th P.venue West <br />PLUh761NG <br />�IdO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET�TOILET) <br />BATHTUB <br />. LAVATORY (WASH BASIN) <br />SHOWER <br />� KIICHEN SINK fl DISP. <br />D�SHlV.�SHER <br />� LAUN�RVTRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />�� VACUU1d BREAKERS <br />� ROOFDRAINS—RAWLFADERS <br />� SINri �SERVICE — BAP, ETCJ <br />� <br />....:�.'inR� SET�?CI: <br />7�' <br />—_' 'ONF <br />R-S <br />r:= cr coNs� <br />V-N <br />.�.7i OF 9LDG <br />Addition 308 <br />-i;.i zowe <br />FE'c <br />TOTAL FE� S <br />SiRF.Ei SGTi3AC1( R6\R YAfiD SETBA <br />25' 25' <br />LOi AqEh VACANT SIIE <br />42098 Sq. Ft .-ves x�n <br />OCCUPANCY 3FOUP NG.OF DWELUIJG <br />Addition R-3 1 <br />No. or sroaies i,�nx occ �ono <br />' 1 <br />' i.ttVl;IONMENTAL CHECK LIST <br />' LiUILDIN4 P(ANS <br />:1 YIRF HVDRANT <br />. F IRG PqOTECTION SYS'EM <br />GRADING <br />5 CR�INAGE <br />Z cNVIqONMENTALIMPACT STATEMENT <br />e r+enu�ii oislaicr <br />nPf9.IC4TICN ACC. �Y PIANS CHECY.ED �Y <br />E.W. I HWM <br />[ rves <br />APPfl. FOR ISSUANCE BY <br />LC <br />I HEREB`.' CERTIFY THAT I HAVE READ AND EXAMINED THi3 AF- <br />PLICATION AND KNOW THF SAME TO BE TRUE AND CORReC�i�. <br />ALL PROVISIONS OF LA\NS AND ORDWANCES GOVERNING Thil; <br />TYPE OF WORtC WILL BE COMPLIED WITH WHETHER SPECIFI� D <br />HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NO�i <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRii� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATIIJC; <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGtlA1URE01'GON�RAGiORURhUTHOR E�AFNi U'i� <br />x 1%�,�.�.�5� �J ° f��,G� 5 <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE � � <br />AIR COND UNIiS — H.P. LA <br />_ FEFRIGERATION UNITS — H P. EA <br />BOILERS — H.R EA. _i <br />GAS FIRF.D 1.G UNITS — TONNAG`c EA. <br />FORCED AIR SYSTEMS — B 7.0 M EA. <br />V/hLL H`tATERS — LSL. b1 <br />UNIT HEATERS — B T.U. Id <br />EVAPORATII�E COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANfII IN(; IINIT — C.6M. <br />IdETAL <br />SUBTOTAL S <br />PEflMIT 5 <br />TOTALFEE S _. J _ <br />IECK NUh7�ER PL�N CHECK FE[ <br />82/10443 FEe 32,g3 aeeei�rr;c <br />57259 <br />FEES VALUATION FEE <br />.DING =5,00� 50 50 <br />M61NG � I <br />_ � I._ _ <br />UBD <br />SEQ 303 (a� <br />50 I 50 <br />V.'HEN PROPERLY VALIDfQED (M THIS SPACE) THIS IS YOUR PERMIT <br />��ig $OS0.50 -- ij <br />�' <br />1'nUQ RECEIPT G' <br />Tf-t�GNN YC� 1,� <br />1 � �:Fii 0.� <br />