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the 6ve/y¢r'een <br />CiTY OP <br />evere�t <br />259-8745 <br />O DEMOLITION <br />- C�NSTRUCTION <br />PERMIT <br />p COMBINATION <br />PERMIT NQ. � J U � � <br />❑ BUILDING ❑ MECHANICAL 'O PLUMBING f� SIGN <br />OWNER �� 1���. �; 1�-' �,`� MniL nwnt>o .,... <br />6ei+wwt USA P.O. Box 220 Seattle, WA 98111 <br />qRCwTELTORDE5IGNER MAiL>�DRE55 CrtY 21P �'HONE <br />GENER�LCONiMCTOR MRRRDDRE55 CItV ZIP PHONE LIGENSE� <br />Meyer Siqn 1689 Fiwy 99 S. Mt. Vernon, WA 98273 424-1325 MEY:i[LSA393DL <br />MECHINiC�LCONTRAGTOR MMIApOR[SS CITY ZIP PHONE UCENSE• <br />PLUMOINGCONTRACTOR MAiLA�DRE55 CItV LP PHONE LICENSE� <br />;�A55OF WORN <br />[d NEW O ADDITION <br />s 3500.00 <br />❑ ALTERATION ❑ flEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />Install new footings and poles, 2 new illum. price signs. <br />O ELECTRICITV <br />�ROPOSED USE OF BUILDiNG <br />Gas Station <br />Fcu oESCRIPTION OF PROPEPTY <br />❑ GAS ❑ WOODSTOVE l� O'fHER <br />LOT _ OLOCN _ O� — <br />OO�ODPESS <br />6731 Beverly Bvld. <br />PLUMBING <br />NO. TYPE OF FI%TURE OR <br />WATER CLOSET (TOILET� <br />BATHTUB <br />LAVATORVIWpSHOASIN� <br />SHOWER <br />NITCNEN SINK 8 OISP. <br />DISMWASHER <br />LAUNOHYTRAV <br />CLOTHESWASMER <br />URINAL <br />DRINNING FOUNTPIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — R 41NLEADERS <br />SINK �SERVICE — IIAR. ETC.� <br />SIZE Oi OLDO <br />FIRE SPRINKLERS R <br />APPLiCRTIONACC M <br />S.H. <br />on <br />I HEREEY CERfIFY THAT I HAVE READ AND EXAMINED THIS <br />APPIIc;ATION AND KNOW THE SAME TO LiE TRUE AND <br />CORRFCT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVE'aNING 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 AUTHCIRITY TO <br />VIOLATE O(i CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGUL..iING CONSTRUCTION OR <br />THE PE (iMAN F CUNSTRUCTION. <br />SIGNATIR 0 C N nC R UTHOfU2E0 AGENT. OR OWNER -`_ G Oj?TE <br />3 08 <br />FEE NO. TVPE OF EOUIPMENT FE= <br />AiC — A!HN�LG UN�TS — H P <br />REFRICFRPT:.iN UNITS — H P. EA <br />BOILERS — 0 T U1NP <br />GAS FIPED A C UNITS — 8 TL <br />FORCE� AIR SYSTEMS — B T.0 M EA. <br />WA'.MEATERS—BTU M <br />UNITNEATERS—BTU M <br />EVAPORATIVE COOLERS <br />CLO1hES ORVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HF.ATER � <br />WOODSTOVE <br />METAL FIREPLACE d CMIM4EY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GA$ PIPING <br />E%HAUSTFAN _ _ <br />SUBTOTAL S <br />PERMIT f <br />TOTRLFEE S <br />lEAHSETBRCN SIDESE11iACN <br />lOT RPEP VRCANT 9 �E <br />❑YES ❑NO <br />OCCUPPNCYGHOUP NOOFOWELLIN(:l1NIL5 <br />NO OF STORIES MA% OCC IOnD <br />I ❑ YES ❑ NO <br />r�nNsc�,ecKconr nvrn �onissunNCEm <br />H.� <br />BE.. <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />.FT eE <br />NO <br />BUILDING 5 3500.00 15 � 00 <br />PLUMBING <br />MECHANICAL . <br />INVESTIGATION FEE ��' ��� ��e) <br />STATE 9UILDING SURCHARGE <br />STA7EENERGYSURCHARGE <br />DRIVEWAV PERMI7 <br />TOTAL <br />PEPMIT VALIDATION <br />WHEN PROPERLV VALID�TED pN THIS $PACEI TMI515 YOUR PERMIT <br />M <br />L.L'] <br />C.G <br />Q) <br />� <br />