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1 "�^ \ <br /> ►►�E�,� • C��TRU��'ION . ��.; ',^� �°` � .. <br /> �,� <br /> �everett . , ,: PERMIT: .. , � PEa�R,�. o�zz3 � <br /> crtvww'zs�s»5 ❑ COMbINAT10N ('� UILDINfi ❑ MECHANICAL ❑ PLUMBIN(i <br /> EVEREff.WA 98201 �-l!� <br /> OWNER 1MIL WDRE55 CItY 2iP PHONE <br /> 98201 252-5559 <br /> Dale Hill 1002 Broadway �n 21P v�oNE <br /> ♦q�HfiECJ qi pE51GNER AMIL ADONE55 ' <br /> GENE�LCONTBACTOR MAILADORE55 GITY 2iP PNONE LICEN��E• <br /> Same <br /> MEGHANIGLCONTRACTOR YML/�ADRESS GTY ZIP PN011E LICENSEI <br /> PLUAIBINGCOMTRACTOP MMI�DRE55 Citt ZIP PHONE I�LEN5E1 <br /> GU55 OF WORN <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI7ION ❑FENCE ❑SIGN GNRhGE <br /> VALU�TION OF WORK <br /> f <br /> DESGPiBE WdM <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> IECa�L DESLRIPiION OF PA0PE9TV ISHOW BEIOW OR ATfACN FOURCOPIE51 PUCATION AND KNOW THE SAME TO BE TRUE AND CARRECT. <br /> ALL PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS <br /> ioT eioc�—oF TYPE OF WORK WILI 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 /> CANSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> S�GNRTURE OF fANTRFCIOR OB NUTHORIZED PGENi OATE <br /> JOB ADDAE55 9/8/B 0 <br /> 1002 Hroadway Avenue X <br /> PLUMBING MECHANICAL <br /> NO. IYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET Q�OILED A'R CONU.UNITS—N.P.EA. <br /> HEFRIGERATION UNITS—N.P.EA <br /> BATHTI�B <br /> LAVATORY(WASH BASW) BOILERS—MP.EA. <br /> GAS FIRED AC.UNITF—TONNAGE EA. , <br /> SHOWER ' <br /> F'ORCED AIR SYSTEMS—B T.U. M EA. <br /> KITCHEN SINK R DISP. <br /> N'ALL NEATERS—B T.U. M <br /> DIS4WASHER <br /> UNIT HLATERS—B TL. M <br /> LAUI'DRV TRAV <br /> EyqppRATIVE COOLERS <br /> CLOTIIES WASHER CLOiNES DRYEfiS . <br /> WATEH HEATER <br /> URINAL VENTILATION FAN <br /> RANGEHO00 <br /> DRINNING FOUNTAIN <br /> FLOOR DRAIN AIR NANDLING UNIT— CF.M. <br /> 1 stove 3 00 <br /> VACUUM BREAKERS <br /> ROOf DRAINS—RAINLEADEPS <br /> METAL FlREPLACE&CHIMNEY <br /> SINK�SERVICE—BAR.ETCJ <br /> SUBTOTAL f 3 00 <br /> SUB T0TI1L = <br /> PERMIT f PENMIT <br />� TOTAL FEE 6 00 <br /> TOTAL FEE : pLpN CNECK FEE <br /> SIDE VARO SETBACK FTREET SETOACK REAR YARD SETBACK PLAN CNECK NUMBER <br /> FEE RECEIPT N0. <br /> USE ZONE LOT AREA VACANT SITE FEES V�tUATION FEE _ <br /> [1VES ❑NO <br /> NPE OF CANST. OCCUPANCY GROUP NO.OF DWLLLING UNITS <br /> UUILDMG $ <br /> SIZE OF BIDG. NO.OF S70PIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENi q[OUIRED KLERS MECHANICAL G OO <br /> f7YE5 ❑NO <br /> APPROVALS <br /> BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALN U B.C. <br /> SEC.3031a1 <br /> 2. BUILDINGPLANS TQTA� 6 00 <br /> 3. FIRE NVDRAN7 <br /> a. FIREPROTECTION�YSTEM PENMITVAUDIITION <br /> WHEN PROPERLV�ALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GMDING � � H E S O O 0.O O �� N <br /> 6. DRAINAGE . N <br /> 7. ENVIRONMENTALIMPACTSTATEMENT <br /> B. HE�LTHDISTRICT YOUR RECEIPT o <br /> , APPIICA'1'ION ACC.BY PUNS CNECKEO BY APPR.FOR ISSUANC:BY T t�i AN K Y O U <br /> . . - 8 �c! OU � <br /> nooRess ei e - <br />