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''�e �,�� T�eo° rO NSTRUCTION <br />ever�tt PERMIT PERMIT N0. 10937 <br />GTY HALL 259�8745 <br />EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING <br />OWNF:N MhILADDNk55 CIiY ZIP PIIONL <br />Robert Jelvik 2218 Virginia Everett 98201 252-5877 <br />ARCN11ECi OR OFSIGNER M41L ADDPE55 GIiY ZIP PI1pqL <br />GCNEPA� �pNiMLLOP NNl AppRC55 GITV ZIP P110irF LICENSE I <br />MfG11ANICALCON1RACiOfi MAllAOUfiE55 qLY 21V PNONE LICFNSEI <br />PWM�INGCOIIIRACIOL 1.1hILAUDRE55 CrtV 2iP PNONE LICENSE� <br />Quil Ceda Construction 9508 State Marysville 98270 659-8050 <br />C1A550i WORK r' 7� <br />❑NEW ❑ADDITIGN ❑ALTERATION ❑PEPAIR ❑DEMOLITION ❑FENCE ❑SIGN []g�flA�tL CC ZOGL% <br />VAWAiION OF WORK <br />S <br />UESCRiEtE WORR <br />USE OF pUIl01NG <br />ICGNI. DFSCRiViION Of PROPERTY �SNOW BEIOW OR <br />LOi BIOCR_OG <br />7402 Beverly Blvd. <br />PLUMBINO <br />N0. TYPE OF FIXTURE OR ITEM <br />WATER CLOS[T ITOILETI <br />LAVATORY <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VALUUId OREANERS <br />ROOi DRAINS — RAINLEADERS <br />SINK �SERVICE — 9AP, ETC � <br />SUBTO7AL <br />PERMIT <br />70TAL FFF. <br />SIDE VARD SETBACK STREET SETl3ACK <br />USE ZO4E LOi AREA <br />TYPE OF CONST. OCCUPANCY GR( <br />SIZE OF BLDG. NO. OF STORIES <br />FIRE ZONE BASEMENT <br />APPflOVALS <br />1. ENVIRONMENTAL CNECK LIST <br />2. UUILDING PLANS <br />3. FIRE HYDFANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTALIMPACi51ATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACG �Y PLANS CNECKED BV <br />R[AR YARD SETBACK <br />VACANT SITE <br />I!VES i1N0 <br />NO OF DIVELLING UI <br />MA% OCC.IOAD <br />FIRE SPRINKLERS <br />REOUIRED <br />�IiYES �lINO <br />BY I DATE <br />APPR.FORISSUANCE �V <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 TIIIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />H[REIN 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 OF CONSTRUCTION. <br />SIGNAN��EO(CONiPnCiO�RO�R/nUL�ORIZFDAGLNt DAiE <br />Y %rnn..� .�C.C/�i�i�n9•� 8/30/82 <br />TYPE OF EQUIPMENT <br />AIR CONL� UNITS — HP EA <br />REFflIGkR�TION UNITS — H P. EA <br />BOIL[RS — H P EA <br />GAS FlHED A G UNItS — TONNAGE EA <br />FORCED AIP SVSTEM3 — 0 T.0 M <br />l'JAIL HEAiEPS — 0 T.U. M <br />UNIT HEAiERS — � T U �•� <br />tVAPORAiNE CCMGRS <br />RANGEIIOOD <br />AIR NfNDLING UNIT -- C F M _ <br />STOVE <br />h1ETAL FlREPLACE 8 CHIMNEV <br />SUB TOTAL f <br />PEHMIT S <br />TOTAL FEE f <br />PIAN CHECK NUMBER PLAN CHECK FEE <br />�E[ REC[WiNO <br />FEES VALUATION FEE <br />�UILDING S <br />PWMBING ] OO <br />61ECHANICAL <br />PENALTY <br />U.BL <br />SEC.3�31a1 <br />VpLI0ATI0N <br />70PERLV VALIDATED (IN iH15 SFAOCE) iH15 �S j ORO �.AO O�� �Q' <br />6oi � <br />. � � � <br />YOU R RECEIPI' � <br />TI-IANK Y�U <br />1 � ' <br />�. <br />30auG $1 , <br />, � <br />ADDRF55 FILF _-- S-= w• � '!„ <br />m <br />� <br />