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dte Evergreett ' ' G��ST R�VTIO N <br /> CITY OP <br /> cveret� P�RMIT PERMIT NO. O�H33 <br /> CIN HALL 259�C%�5 <br /> ever�Err.�'+r, �az, i ❑ COMBINATION �cBUILDING ❑ MECHANICAL PLUMBING <br /> W:IlEN <br /> MPiI pUUFL55 LIiY ZIP PXONE <br /> S & M Auto Parts 2718 Broadway Everett 98Z _ _ <br /> 4aO1rtECi OA 061G:FR <br /> MAILAODRESS Crtv LP PnONE <br /> GCNEAAICANiRAGTJR <br /> MNiL��DRE55 :ITV ZiP MONE LIGENSE� <br /> Simco Siqn Corp 2719 Maple Everett 98201 252-0086 SI MC�NOS C27cEPE. <br /> IAEC11A�dGAL CAN�RACLOR <br /> MAIL pDORE55 GTY Z�P <br /> PLUMBING CONTfUCTOR <br /> MAILAp�RE55 CIiY ZIG MONE UCENSEI <br /> C1A550f WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑OEMOLITION ❑FENCE XPSIGN GARAGE <br /> VPWATION O�WORK <br /> S 35�0.0� <br /> oeseaiee woa� <br /> install illuminated uign <br /> PR04'OSED USE OF BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THI � <br /> ieenioEscaienonoFmovearrisNowee�owoannne�iFom+eowcsl FLICATIOIJ AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF IAWS AND ORDINANCES�OVERNWG THIS <br /> ior e�a�—oF TYPE OF WOf7K WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES N0T <br /> PRE.iU ME TO GIVE AUTHORIT`!TO VIOLATE OR CANCEL TH E PRO� <br /> VISIONS OF AIJY OTHER STATE OR LUCAL LAW REGULATING <br /> CO�STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> � SIGNAtUPL OF CA OR OR AUtNOPi2iJ AGENL 0 •E (/� <br /> J�B ADJRE55 X �/� � ZS fJ <br /> 2718 Broadway <br /> MECHANICAL <br /> PLUMBING FEE <br /> TYPE OF EOUIPMENT <br /> Np, TYPE JF FI%TURE OR ITEM FEE NO AIR COND.UNITS—HP.EA. <br /> WAT[P CLUSET(i011 ,) - <br /> REPRIGERATION UNITS—N P.EA <br /> BATNTU� <br /> _ BOILERS—H P.EA. <br /> LAVATORV(W45N BP.SIN) <br /> GAS FlRE�A C.UNITS—TONNAGE EA. <br /> SNOWER FORCED4IPSYSTEMS—BLU. ME.4. <br /> KITCHEN SINK 6 f`ISP. _. — <br /> WAILHEATEFS—�1.U. M <br /> �ISNlVASHER M <br /> UNIT HEATEAS—9 T.U. <br /> LTUNDRYTftAY _ <br /> EypPORATNECCOLERS <br /> CLOTHES WASNER CLOiNES ORYERS <br /> WATER HEATER <br /> _ VENTILATION FAN <br /> UPINAL RANGE HOOD <br /> �RI.'JKING FOUNiAM pIR HqN�LING UNIT__.___ QF.M. <br /> FLOOfi ORAIN STOVE <br /> VACUUM BRFAKER7 METAL FIFEPLACE 8 CHIMNEY <br /> ROCf GRAINS—�AINL�ADEPS <br /> �INK�SEFViCE—O�R ETCJ '--- <br /> SUBTO7AL f <br /> SUB TOTAL pERMIT s <br /> PENMIT s <br /> TOTAI.FEE f TOTPL FEE s <br /> PLAN CHECK FEE <br /> SIDE YARD 6ETBALK STREET 5[T�nCK REAR YARD SETBACK PLAN CHECK NUMDER FCE pECEIPT h0. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> L]YES ❑NO <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS ],Z OO <br /> ' BUILDING b 3$��. <br /> SIZE Of BLDG. NO.OF STORIES MA%.00C.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIREO <br /> IIYES ❑NO <br /> APPROVALS <br /> BY DATE OTHER _ <br /> L ENVIRONMENTAL CHECK LIST PENALTY U�.C. <br /> SEC.303(a) <br /> 2. BURDINGPU+NS TpTA� � 12 OO <br /> ��� <br /> 3. FIRE MYDRANT <br /> PENMIi VAIIDAiIUN <br /> � 4. FIFE PROTECTION SYSTEM WHEN PROPEf7L1'VALIDATED(IN THIS SPACL)THIS IS YOUR PERMIT <br /> M <br /> 5. GRAUING . � ' '� I � 1) I L. IJ l' t^� <br /> 6. DPAIVAGE . . . . <br /> 7. ENVIRONMENTALIMPACTSTATEMENT � <br /> B. NEALTH DISTflICT . , _ , � i�-,— � <br /> APPR.FOR ISSUANCE BY , �� I <br /> APPLICATlON ACC.DY F�.ANS CHeCKED BY � �� � � <br /> � Rp BAB . ..�, � ') � <br /> ADDRESS FILG ' ' <br />