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thc��'CTreOF � . CjONSTRUCT�4 \ <br /> everett p�R� IT PERMIT I�O. 12675 <br /> CITY HALL 259�8745 <br /> EVERE77,WA 98201 ❑ COIdBIf�ATION I�t BUILDING ❑ MECHANICNL ❑ PLUM9ING <br /> OWNER MAIIAUDRE55 CITY 1 PHONE <br /> Thriftway 4915 Evergreen Way Everett 9�g03 <br /> . AflCHITECT OR DESIGNER MAIL AODf1E55 CITY ZIP PHONE <br /> GENEPAL CONTRACTOR MAIL ADORE55 qTY ZIP PHONE LICENSE 1I <br /> Heath N.W. Inc. 11805 N.E. 116th Street Kirkland 9803' 623-3100 <br /> MEGMAN�CAL WNTRFGiOR IAAIL AO�RE55 CITY ZIP PHONE LICENSE M <br /> HEAT7IN*330R3 <br /> PLUMBItIGGONTRAG�OR MAILAO�RESS CITY ZIP PHONE LICENSEa <br /> CLA55 OF WORK <br /> ❑IIEW CI ADDITION C ALTERATION ❑REPAIR ❑ DEMOUTION ❑ FENCE �(SIGN O WOOD SiOVNFIFIEPLACE INSERT <br /> VAIUATION OF WORft <br /> S FJ����.'J� <br /> DESCRIBE WORK <br /> Install sign_qllt • <br /> PiiOPOSE�11EE OF 9UIL�ING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMI�IED THIS <br /> APPLICATION ANIJ KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIPTIONOFPROPEPTY�SHOWBE�OWORATiALMFOUHCOPIEF.� CORRECT. ALL PRUVISIONS OF LAWS AND ORDINANCES <br /> LOT_BL(1CK_OF GOVERNING THIS TYPE OF WORK WILL BE COMPLiED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERPA�T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONST UCTION OA THE <br /> PEFF ANCE ON RUCTION. <br /> JOB A�ORE55 SIGN URE F CONT R AU ORIZEU AG T O,/ATE <br /> 9919 Everyreen Way X I -b.3 <br /> PLUMBIMG MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAfERGLOSET�TOILEn AIR COND.UNITS— H.P. EA. <br /> BATHTUB REFRIGERA710N UNITS— H.P. EA. <br /> LAVATORY(WASH BASIN) BOILERS— H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS—70NNAGE EA. <br /> KITCHEN SINK 8 DISP, FORCED AIP SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRYTRAV UNITHEATERS— B.T.U. M <br /> CLO7HES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER ��_OTHES DRVERS <br /> URINAL VENTILA710N FAN <br /> �RINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF�RAINS— PAINLEAOERS METAL�IREPLACE 8 CHIMNEY <br /> SINK(SERVICE— B4R, ETC.) FIREPLACE INSEFT <br /> HEAT PUMP <br /> SUB TOTAL 5 SUB TOTAL S <br /> PEHMIT S PEHMIT 5 <br /> TOTALFEE S TOTAL FEE 5 <br /> SI�E YARD SETBACK STREETSE70ACK REAR YPRD SETBACN PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIP7 NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> "-:YES CNO FEES VALUATION FEE <br /> TYPE OF CON57. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> SIZE OG BLDG. NO.OF STORIES MAX.OCC. LOAD BUILDING g S�000.00 18 00 <br /> PLUMBING <br /> FIRE ZONE BASEMEN7 FIRE SPRINKLEFiS MECHANICAL <br /> RE�l11RED <br /> DYES GNO <br /> APPROVALS BY DATE O7HER <br /> 7.C-NVIRONMEYTAL CHECK LIST pENALTY U.B.C. <br /> —. SEC.303(a) <br /> 2.BUILDINGPLANS 1$ OO <br /> 3.FIREMVDRANT 70TAL <br /> 4.FIRE PRCTECTION SYSTEM PERMIT VALIDATION � <br /> 5.GP.ADING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT LI) 1 <br /> 6.DRAINAGE �� � 9 Q � O � V• a O ��� .� <br /> 7.ENVIRON MENTAL IMPACT STATEMENT �y <br /> B.HEALTH DISfRIGT t._� <br /> APPLICATION ACC.BY PlANS CHECKED BY APPR. FOR ISSUANCE BY �-;�( j �„� ^ ;;EC r I PT <br /> � � ;!-�,�rt�: Y� u <br /> ADDRESS FILE I C ���1� S� <br /> I ._ <br />