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!hr Ll•er,�reen <br /> �"Y �� r-- ;orusT�ucTior�- - <br /> everett PERMIT PERMIT NO. 16470 <br /> CITY HALL 25g.87d5 <br /> EVEFETT,`NA98201 � COMBINATION ❑ BUILDING C� MECHANICAL ❑ PLUMBING <br /> OWN[N MAI�ADORE55 CIfY ZIP PHONE <br /> CLARK HOOVER 4919 EVER6REEN WAY EVERETT WA 98203 259-9262 <br /> ARCHRELT OR DESIGNER MAIL AD�FE55 CITY ZIP PHONE <br /> GENERAL CONTPACTOfl MAIL AODRESS CITY ZIP PHONE LICENSE N <br /> MECHANICAL CONTflACTOfl MAIL AODRE55 CITY ZIP PHONE LICENSE M <br /> HUSSMANN REFRIG 7440 W MARGINAL WAY S SEATTLE WA 98108 763-9050 <br /> PLUMBING CONTRACTOR MAIL PDORE55 CIT'f ZIP PHONE UCENSE N <br /> CLA55 OF WORK <br /> O NEW L�(A�DITION ❑ ALTEFATION ❑qEPAIR ❑ OEMOLITfON ❑ FENCE ❑ SIGN ❑ WO00 S70VEIFIREPLACE INSERT <br /> VALl1AT10N OF WONK <br /> S <br /> DESCRIBE WORK <br /> Install two Type I hoods with fans <br /> PROPOSE�USE OF BUILDING <br /> GrOCery StOre I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGA_OESCRIPTION OF PflOPERTY(SHOW BELOW OR ATTACH FOIIR COPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS qF LAWS AND ORDINANCES <br /> LOT__BLO.^,K_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTIG�J. <br /> JOB ADDRESS SIG CONTR R OR AU NORIZEO AGENT UATE <br /> 4919 Evergreen Way X �/25/86 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn Alr�CONO. UNITS— H.P. EA. <br /> BA7HTUB REFRIGERATION 11N1T5— H.P. EA. <br /> LAVATORY(WASH BASIN) BOILE(75 — H.P. EA. <br /> SHOWER GAS FIRED A.C. UiJIfS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATEFS— B.T.U. M <br /> LAUNDFYTqAY UNIT HEATERS— B.7.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEFS <br /> WATER HEATEFi CLOTHES DRVERS <br /> URINAL 2 VENTILATION FAN <br /> DRINKING FOUNTAIN 2 RANGE HOOD <br /> FLOOR DRAIN AIR FIANDLING UNIT— C.F.M. <br /> VACl1UM BREAKERS STOVE—WOOD <br /> ROOF�RAINS— RAINLEA�ERS METAL FIREPLACE&CHIMNEY <br /> SINK(SERVICE— BAR, ETC.) F�REPLACE INSEfiT <br /> HEAT PUMP <br /> SUB TOTAL 'a SUB TOTAL 5 �8 QQ <br /> PERMIT S PEHMIT 5 � O OO <br /> TOTAI FEE S TOTAL FEE S 2$ OO <br /> SIDE YARD SETBACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUM9ER PLAN CHECK FEE <br /> FEE RECEIPT N0. <br /> USE ZONE LOT AREA VACANT SITE <br /> ;:YES C:NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO. OF DWELLING UNI75 <br /> BUILDING S <br /> SIZE OF BLOG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING <br /> FIRE 20NE BASEMENT FIRE SPHINKLERS MECHANICAL <br /> FEOUIRED <br /> GVES �;NO Z8 OO <br /> APPNOVALS BY UATE OTHER <br /> 1. ENVIRONMENiAL CHECK LIST U.B.C. <br /> PENALTV SEC.903(a) <br /> 2.BUILDING PLANS <br /> 3.FIREHYDRANT TOTAL ZH OO <br /> 4.FIRE PROTECTION SYSTEM PEpMIT VALIDATION <br /> 5.GRADING WHEN PROPERL:'VALIDA7ED(M THI$�PAC�)THIS�ISI�Y�U�j P�RMIT _ ;.� <br /> 6.DRAINAGE � <br /> � <br /> 7.ENVIRONMENiALIMPACTSTATEMENT <br /> B.HEALTY.DISTRICT �`�' <br /> APPLICATION ACC.8Y PLANS CHECKED BV APPR.FOR ISSUANCE 8Y � � - ' � <br /> i I c-; <br /> , '1 <br /> � <br /> , , ;� � �; <br /> ADDRESS FILE <br />