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the Evergreen CITYOFF - CONSTRUCTION - <br />CITY <br />everett PERMIT PERMIT NO.0668Q <br />CITY HALL 25E 745 <br />EVERETT, WA 3B201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNLB MAIL AUDRESS ❑Ih ZIP PHONE <br />ELLA PELKEY 1702 62nd st 98203 353-3293 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE [ <br />MECHANICAL CONTRACTOR A AIL ARDRESS CITY ZIP PHONE LICENSE G <br />SELF <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PRONE LICENSE G <br />CLASS OF YIL K <br />KNEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />f <br />OF <br />LOT BLOCK_" <br />22.5 KW <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP - <br />OR ATTACH 'JURCOPIES) PLICATION AND KNOW THE. SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PI:O. <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE Of CCOOONTRACTOR OA I IwHOR17{ I, � II NT DATE <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT _ FEE <br />WATER CLOSET (TOILET) AIR CORD UNITS — H.P. EA <br />BATHTUB REFRIGERATION UNITS — H P EA <br />LAVATORY ASH BASIN ROILERS — H P. EA. <br />SHOWER ,TAS FIRED AC UNITS — TONNAGE EA <br />KITCHEN SIN6'. DISP. FORCED AIR SYSTEMS — D T U M EA. <br />DISHWASHER WALL HEATERS—BT.U. M <br />HFATGRS - <br />BTU M <br />WATER <br />SIDE YARD SETBACK STREET SETBACK <br />USE ZONE LOT AREA <br />TYPE OF CONST. OCCUPANCY GROUF <br />SIZE OF BLDG. NO. OF STORIES <br />FIRE ZONE BASEMENT <br />APPROVALS <br />1, ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />e, DRAINAGE <br />7, ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />REAR <br />❑YES LINO <br />APPLICATIJN ACC. BY I PLANS CHECKED BY I APPR. FOR ISSUANCE BY <br />METAL <br />CHECK <br />FEE <br />i <br />MECHANICAL <br />PENALTY I SEC 303(a) <br />TOTAL <br />RECEIPT NO. <br />WHEN PROPERLY JALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />2215 i00=.OQ+M00 <br />YOUR RECEIPTE2 <br />THANK YOU <br />