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rhr £�•ercrrrn <br />everett � %ONSTRUCTIO�� � <br />PERMIT PER�nir No. 1G537 <br />CITY MALL 259�6745 <br />EVERETT,WA98201 n COMBINATION ❑ B'J!LDING ❑ MECHANICAL ❑ PLUMBING <br />R� <br />OWNER MAIL ADORE.iS CItY ZIP PMONC <br />TIME OIL CO PO BOX 24447 SEATTLE WA 98124 285-2400 <br />RRCnITEGi OR DESIGNER MAIL AOORE55 GTY ZIP PMONE <br />GENERAL CONTqAGTOR MAIL AOORE55 CITY ZIP ri1GNE UCENSE M <br />SAME <br />MEGHANICAI CANTRRCTOR M41L ADDRE55 CITY ZIP PNONE LICENSE II <br />PLUMBING CONTFACTOR MAIL ApORE55 CITY ZiP CMONE LILENSE � <br />CU55 OF WORM � <br />O NEW IA ADDITION ❑ ALTERATION � REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />VALUATr�ION OF WORN <br />i G0��00. <br />DESCRIBE WOR1c <br />17'xll' addn to existing building <br />Convenience stoi•e <br />LOT _ 9LOCN _OF <br />17-29-5 Por NE1/4NE1/4NW 1/4 <br />�s-�- iv, aro-adwa <br />PLUMBING <br />TYPE OF PIXTURE OR ITEM <br />WATEN CLOSET ITOILEn <br />BATHTUB <br />�AVATORV(WASH BASIN) <br />SMOWEti <br />KITCHEN SINK 8 DISP. <br />DISHWASNER <br />LAUNDRYTqAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />flOOF DRAINS — RAINLEADEFS <br />SINK (SERVICE — BAR. ETC.) <br />�UB 70TAL <br />PENMIT <br />TOTAL FEE <br />)E VARD 3ETBACK STREET.SETBACK <br />0 Q <br />E IONE LOf AREA <br />B-2 19,000 sf a <br />V-N B-1 <br />SiZE OF BLDG. NO. OF S70R <br />]87 sf addn 1 <br />fIRE ZONE BASEMENT <br />APPqOVAIS <br />1. ENVIROIJMENTAL CHECK L.ST <br />2. BUILDING PLANS <br />J. FiRE HVDRANT <br />4. FIRE PROTECTION SYSTEM <br />S.GRADING <br />fi.DRAINAGE <br />7.ENVIRONMENTALIMPACTSTAiEMENT <br />B. HEALTH D�STRICT <br />mm <br />FEE <br />� <br />S <br />S <br />REAR VARD S <br />� <br />VAGANT SITE <br />L:YES f%IJO <br />NO. OF DWEL <br />0 <br />MA%. 000. L <br />na <br />FIflE SPRINK <br />REOUIRED <br />YES NO <br />BY <br />BY IAPPH. <br />jef � lc <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TIiIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINAhCfS <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VVI1"H <br />WHETHER SPECIFIED HEAEiN OR NOT. THE GRANTING OF A <br />PERMITDOE TPRESUMETOGIVEAUTHORITYTOVIOLATE <br />(�R CANCE TH PROVISIONS OFpt� Y OTHER STATE OR <br />Li4GAL LA R Cs1it'7{iING CONSIIRUCTION OR THE <br />MECHANICAL � <br />NO. TYPE OF EOUIPMENT <br />AIR COND. 11NITS — H.P. EA. <br />REFRIGERATION UNI7S — H.P. EP. <br />BOILERS — H.P. EA. <br />GAS FIRED A.G UNITS — TONNAGE FA. <br />FOFCED AIR SYSTEMS — B.T.U. M EA. <br />N/ALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORA7IVE COOLERS <br />CLOTNES DRVERS <br />Z VENTILATION FAN <br />j RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />ME7AL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />NEAT PUMP <br />ETBACK PLAN CHECK NUh <br />86/16537 <br />FEES <br />LING UNITS <br />BUILDING <br />OAO — <br />PLUMBING <br />LEF75 MECHANICAL <br />DATE OTHER St <br />PENALTV <br />S <br />DATE <br />rte <br />SUB TOTAL f j O <br />PEHMIT f <br />TOTAL FEE S j O <br />PLAIJ ;HECK FEE <br />FEE g� , 33 FiECE1PT NO. <br />7 9057 <br />VALUATION FEE <br />E�n nnn inc <br />TOTAL I ^`^^'�"'^" A4ih <br />domi�;� �.� <br />PEHMIT VALIOATION <br />WHEN PROPERLY VALIDATED pN �:iPACE) Ti�UR PERMIT <br />2 additional parkin es � street - <br />are required � f17� <br />ADDRESS FlL[ <br />