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the Evergreen P O N CST R 1 CT I O N <br />CITY Of everett PERMIT PERMIT NO.09134 <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 P COMBINATION �� BUILDING I I MECHANICAL PLUh791NG <br />O i.ill ' . `�•1 " IIP <br />James Anstis 420 92n.4 Street Everett 98204 255-5465 <br />ARCHITECT OR UESIGNER MAIL ADDRESS CITY I — - — — — - z7,— DONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY Z, PNONE 1!1-EtbE0 <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />CLASS OF WORT E <br />❑NEW ❑ADDITION ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />31000.00 <br />;CRIBE WORK <br />remodel kitchen area <br />)POSED USE OF BUILDING <br />single fam':y residence <br />LOT BLOCK_OF <br />JOB ADDRESS <br />420 92nd Stx <br />PLUMBING <br />NO. TYPE 0 <br />_ WATER CLOSET OIL <br />BATHTUB <br />LAVATORY ASH BA <br />SHOWER <br />K'TCHEN SINK S DISI <br />_ DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL _ <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM PREAKERS <br />ROOF DRAINS - RAI <br />SINK (SERVICE - BAI <br />SIDE YARD SE',BACK I : TREET SETBACK I REAR YARD SETDACK <br />USE ZONE LOT AREA VACANT SITE <br />LIVES ❑NO <br />TYPE OF CONST I OCCUPANCY GROUP I NO. OF DWELLING UNITE <br />SIZE OF BLDG I NC OF <br />I. ENVIRONMENTAL CHECK LIST <br />2, BUILDING PLANS <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYS�E <br />5 GRADING <br />S DRAINAGE <br />Lll 7. ENVIRONMENTAL IMPACTSTATEMENT <br />S. HEALTH DISTRICT <br />APPLICA}ION VTR <br />BY 41LANS CHECKED BY APPR. FOR ISSUANCE BY <br />--f <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />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 PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE 01 CONSTRUCTION. <br />SIGN LIFE OF CONTPACTOROR AUTHORIZED AGENT DATE <br />x z _ _ _ _ D /J_ _ �- 4/14/81 <br />NO. TYPE OF EQUIPMENT FEE _ <br />AIR COND UNITS - H P L.A <br />REFRIGERATION UNITS - H.P EA <br />BOILERS - H.P. EA _ <br />GAS TIRED AC. UNITS - TONNAGE EA <br />FORCED AIR SYSTEMS - B.T.0 M EA. <br />WALL HEATERS - B.T.U. _ M <br />_I JNIT HEATERS -8T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE <br />METAL FIREPLACE S CHIMNEY <br />FEE <br />RECEIPT NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$1000. <br />17 <br />50 <br />PLUMBING <br />2 <br />F00 <br />MECHANICAL <br />OTHER <br />PENALTY <br />UBC <br />SEC 303 Of <br />TOTAL <br />19 <br />50 <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PE7RMIT <br />r 7t I':1/.E',I'A <br />n <br />a) <br />II I n <br />;1 <br />rl� ADDRESS FILE ? `' <br />