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. lheEvergreen � C(�STRUCTt�N � <br /> qT`!OF <br /> eve�e�t PERMIT pERMIT N0. 06403 <br /> CIT'! HALL 259�0745 � <br /> EVERETf,`NP 9ezoi ❑ COMBINATIOtJ ❑ BUILDING ❑ MECHANICAL � PLUMBING . <br /> pWNER MFILADD4iE55 CIiV 21P PHONE <br /> Rubert Sipe 830 Broadway N. 252-1947 <br /> PR'�HRECT G��ESIGNEP MAI�P�DRE55 CItY ZIa PHONE <br /> GE <br /> NERFLCONiRFCiDfi MAILA���E55 CIiY :JP PHOHE JCENSEI <br /> Same <br /> A!ECl/ANICRL CANTPACiOP MAIL A�DRE55 CITV 21P PHONE LICENSE I <br /> PWMdINGfANiRAGTOR MAI�A'J�RESS CItY ZiP FMONE I.ICENSE� <br /> CLA550'WORK <br /> ❑NEW ❑ADUITION L7ALTERATION ❑RLPAIR ❑DEMOCTION ❑FENCE ❑SIGN ❑GARAGE <br /> VPWAii040F WORK <br /> E — <br /> DESCRIBE Y/ORK <br /> Install 3/4" copper pipe 1=ne from property line to r.esidence _ <br /> FAO�OSEO USE OF B�IWING <br /> I NE:FEBY CERTIFY THAT I HAVE READ AP!D EXAMIP!ED THIS AP� <br /> �ecn.�.oescHienuN ov vnoaearr isHow ee.ow o�+nirncN Foun coares� PLICATIOiV AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ioT e�ocK_oF _ TYF'E OF WOHK WILL BE COIdPLIED WITH WHETH[R SPECIFIED <br /> HE�aEIN OR tJOT. THE GRANTING OF A PER�11T DOES NOT <br /> PR=SUME TO GIVE AUTHORITY TO VIC`LATE OR CANCEL THE PRO� <br /> -- VISIONS OF AN`f OTHER STA7E OR LOCAL LAW REGULATING <br /> CCNSTRUCTION OH THF PERFORMF.IJCE OF CONSTRUCTION. <br /> pJlq$ — X'JATU Opq F I.CM1�RAGIOR OR FUiHORIZED,6[u DFtE <br /> JO'3A1jE151 lst}1 Street ✓ v- ,�� � 7/23/ 79 <br /> ��-�.- . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FiXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT _ FEE <br /> NlFTER CLOSF.T(TGILET) dIR CONJ.UNITS— H.P_Li�. __. <br /> �ATHTUB HEfRIG[RATIONUNIiS—H.P. EA _ <br /> LAVATORY�YASH�ASIN) BOILEiiS—F�.R EA. <br /> SHOWEIi G�5 HRED A G UNITS—TONNAGE EA. <br /> KITCHEY SINK&DISP. FORCED AIR SYSTEMS—B T.0 M EA. <br /> DISHWASH[F �NALL HEATERS—B T U. M <br /> LAUNDRY TRAV UNIT HEATERS—B.T.U. �+� _ <br /> CLOTRES YlASHF.F E�AFORATNHCOOLERS <br /> WATER HEATER CLOTHES DRY[RS _ <br /> — — V[NTILATION FAN <br /> UHINAL — <br /> DRINKING FOUNTAIN RANSc HOGD <br /> — F1'A HFNDLING UNIT— GEM. <br /> FLOOR DRAIIJ <br /> VACUUM BREAKERS .`TOVE _ — <br /> fiDOF DRAINS—FAWLEAUEPS METFL FIREP� . `d CHIMNEY _ <br /> SINK(SERVICE—�AR.ETG� <br /> 1 water line <br /> SUB TOTAL Z OO SUB TOTAL f <br /> PEfiM1T 5 3 PEfiM1T 3 <br /> TOTALFEE 5 TOTALFEE s <br /> SIDE YARD SE'BACK STREET F.`.TBACK REAR YARD SETBACK PLAN CHECK NUh12EF: PLAN CHECR FEE <br /> FEE RECEIPT NO. <br /> USE ZOhE WT AREF VACANT SITE FEE <br /> LYES ❑NO FEES VALUATION <br /> TYpE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNI15 _ <br /> BUILDING � <br /> SIZE OF BLDC. NO.OF STONES A9N(.CY'.,C. LOAD <br /> PLUMBING S OO <br /> fIRE7.ONF. BASEMENT FIRESPFINKLERS MECHANICAL <br /> REOUIRED <br /> ❑YES ❑NO <br /> APPROVALS BY DHTE OTHEP _ <br /> 1. ENVIRONMENTAL C4ECK LIST PENALTY U B.C. <br /> SEC.3031a) <br /> 2. BUILDIN3PLAN5 TOTAL , S 00 � <br /> 3. FIRE HYDFlANT �� <br /> a. fIF[PROTECTION SYSTEM PERMIT VALIDATION T <br /> _^_ WHEN PROPERLY VALIDA?ED QN HIS SPACF:)THIS IS YOUR PERMIT <br /> S. GRADING 9 7 61 �. ;p O�, U o '.�� � <br /> fi. DRAINAGE <br /> 7. ENVIflONMENTALIMPACT:'�TATEMENT � <br /> U. HEALTH DISTRICT �'O�U R RE'�'E�lP'!' � <br /> APPLICATION ACC.DY PLAVS CHECKED BY A�PP.FOR ISSUAMCE BV �f"�AIY K YO�j <br /> 2 3 �ut 79. <br /> P,C�RE55 FILE <br />