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dieErrrx�rrcn - �-�NSTRUCTION �- <br />r iir (i� � <br />everett PERMIT PERMIT NO. 13504 <br />CITV MALL 2598745 <br />EVERETT,WA98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNC.R MAILADDRESS CIiY ZIP PMONE <br />MOBSL 928 N. Broadway <br />ARGnrtEGT ON �ESIGNER MAIL ADDRE55 GITY ZIP PHONE <br />GENERALLONTPAGiOR MAILADDRE55 CITY ZIP PMONE LIGENSEN <br />Tube Art Displays PO Box C19013 Seattle WA 98109 284-0420 30889 <br />MECMANIGAI GONtqq�iOP MAIL AD�RESS GITY ZIP PMONE iICENSE N <br />PWMBINGGONTRAGTOR M�ILADUflESS CITY ZIP PHONE UGENSE� <br />❑ NEV✓ O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION O FENCE CXSIGN O WOOD STOVfJFIREPLACE INSERT <br />t <br />ior <br />c:c.�s:� <br />ADDRE55 <br />PLUMBING <br />OF FIXTURE OR ITEM <br />W ATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY(WASHBASIN) <br />SMOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTFAV <br />CLOT11E5 WASHEN <br />WATER HEATER <br />URINAL <br />DR�NKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS - RAINLEADERS <br />SINK (SEFVICE - BAR, ETC.1 <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />SIZE OF <br />APPROVALS <br />L ENVIRONh1ENTFL CHECK LIST <br />2. BUILD7NG PLANS <br />3. FIqE HYDRANT <br />4. FIRE PROTECTION SVSTEM <br />5. GPADi Nf <br />G. �RAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B.HEALTM DISTRICT <br />� <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVCRNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CqN$TRUCTION. <br />� <br />MECFiANICAL <br />N�- <br />f <br />S <br />f <br />REAR YARD SET9ACK PLAN <br />VAGANT SITE — <br />YES : NO <br />BV <br />APPR.FORISSUANCE <br />AGENT �FTE <br />� �� y. <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — M.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL MEAiERS — B.L.U. M <br />UNIT HEAiERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLO7HES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR MANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE d CMIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />OUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />SUBTOTAL S <br />PERMIT f <br />TOTAL FEE f <br />PLAN CI <br />FEE <br />VALUATION <br />£ 1200.00 <br />FEE <br />RECEIPT NO. <br />FEE <br />fOTAL I I . 9 I�0 <br />PEPMIT VALIDAT�ON <br />WMEN PROPERLY VALIDATE� (IN TMIS SPACE) THI$ IS YOUR PEFMIT � <br />°=�� '��'09. �-� <br />; Qu <br />m <br />:: . . ' � r -� •-� <br />. �.� <br />AUDRc55 FlLE <br />� � � ti U'I <br />�� <br />