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�he Ll'erArren <br />��,��� <br />everett <br />CITY HALL 259�87�5 <br />� coNST�ucTicy <br />PERMIT PERMIT NO. 1571� <br />EVERETi. WA 98201 ❑ COMBINATION C�x t BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MRIL 4CDRE55 CITY 2iP PMONE <br />Tyee Lanes 914 North Broadway Everett 98201 <br />ARGNITECT OP pE9GNER MAR 4��RE55 GTY IiP PNONE <br />GENENAL CONTRRQOP MAIL 40DRE55 GTY 21V PHONE LIGENSE ♦ <br />Tube Art Signs 2719 Maple Street Everett 98201 252-0086 <br />MEGMnNICnL CONTqALTOR MAIL ADDRE55 CITY 21P PMONE LICENSE � <br />TUBEASI 161BM <br />PLUMBING CANTflRCTOR MAIL AO�RESS CITY ZIP PNONE LICENSE • <br />O NEW ❑ ADJITION ❑ ALiERPTION O HEPAIR ❑ DEMOLITION ❑ FENCE �{ (SIGN O WOOD S70VFJFIREPLACE INSERT <br />.UATION OF WORR <br />! %0�.0� <br />Install illuminated sign <br />�FOPOSED WE OF BUIIDMG <br />EGAI DESCRIPTION OF P(.OPERTY �SNO W BELOW OP <br />LOT_BLOCK_OF <br />i0B A�DRE55 <br />914 North Broadwa;y <br />PLUM8ING <br />N0. TYPE OF fIXTURE OR ITEM <br />WATERCLOSET�TOILEn <br />BATHTUB <br />LAVATORV(WASH BASIN� <br />SHOWER <br />KITGHEN SINK 8 DISP. <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DPAIN <br />VACUUM BREAKERS <br />ROOF DRAINS - RAINLEADERS <br />SINK�SEFVICE - BAR,ETC.) <br />SUB TOTAL <br />PEPMIT <br />TOTAL FEE <br />OF �LDG. I NO. OF STORIES <br />APPPOVALS <br />1. ENVIRONMENTAL CNECN LIST <br />2. Bb�_DING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SVSTEM <br />5. GRADIN': <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B.HEALTH DISTRICT <br />�S <br />REAR <br />YES : NO <br />Mq7.. <br />NO <br />DATE <br />BY IAPPR. <br />NV/LC <br />I HEREBY CERTIFY "fHAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOV✓ THE SANE TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMlT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OF� CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR �HE <br />PERFORMANCE OF CONSiRUCTION. <br />SIGNATOFEOFCONi9ACTOV01iAUC011ilEDAGENT .OATE . <br />MECHANICAL <br />N0. TYPE �F EQUIPMENT <br />AIR GOND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — M.P. FA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNItS — iONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOO� <br />AIN HANDLING UNIT — C.F.M. <br />srov� — w000 <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSEFT <br />HEAT PUMP <br />SUB TOTAL <br />PERMIT <br />TOTI.: FEE <br />INUMBER F <br />FEE <br />FEES VALUATION <br />BUILDiNG <br />PLUMBING <br />MECHANICA�. <br />OTHER <br />S 700. <br />FEE <br />� <br />f <br />S <br />CMECK FEE <br />RECEIPT NO. <br />FEE <br />� <br />PENALTV SECV3031a1 <br />TOTAL S OO <br />PEPMIT VALIOATION <br />WMEN PROPERLY VAIIDATEO (IIJ THIS SPACE� THIS�S�VQj1�PF�71AlT— f�-� <br />�)g.r' � �u <br />�... <br />�r . <br />BY `... ., : 1\�::rC�i,�• • <br />, ' .'�'I�� ��� �J <br />ADDR[SS FILF <br />,I <br />i,, i � J <br />2 <br />0 <br />1 <br />ci <br />m <br />�� <br />.� -� <br />�n x <br />m <br />C O <br />m� <br />O 3 <br />m <br />-� z <br />m� <br />q Z <br />C <br />D � <br />rx <br />.-. .ti <br />-�i � <br />� <br />� <br />� A <br />3 <br />-i m <br />x <br />m� <br />N <br />0 <br />o r <br />c� m <br />c v+ <br />3 � <br />m <br />Z f'f <br />�r <br />. m <br />n <br />� <br />� <br />2 <br />a <br />z <br />� <br />x <br />N <br />2 <br />O <br />_� <br />f'f <br />m <br />