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� � <br /> ; <br /> c� '�, <br /> drr L\rr¢rcen ;- _ . , �G N ST R l,i�T I r��V � � <br /> CiiY C�F _� ' <br /> everett PERMIT PERMIT NO. 13515 <br /> GTV MALL 259�8745 <br /> LVERETT,WA98201 � COMBINATION (�I BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MA4q0�AE55 CiTY ZiP PNONE <br /> �IM CLINE 2609 CD]hv Avrnua Fvaratt WA qA2f11 _ 75a_�ROD <br /> •HLMIiEGT OR DESIGNER MR L ADOPE55 CITV ZIP PHONE <br /> GENERAL LGNTRPLiOR MAIL 4DDRE55 CITY ZIP PHONE LICENSE M <br /> Same <br /> MECMNNIG�L CONTR�LTOR NAIL AO�HESS LITY ZIP PNONE LICENSE N <br /> PLVMBING CONTRAGTOR MRIL ADUflESS CITY IIP aMONk LIGENSE M <br /> CUSS OF WOflN <br /> O NEW ❑ADDITION �(ALTERATION ❑REPAIR O �EMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br /> VAll1RTI0N OF WOFN <br /> y25����. <br /> �ESCRIBE YlORN <br /> Chanqe storefront, remove wall , add stairs and fire exits, add dressing rooms <br /> PROPOSE�USE OF BUIL�ING <br /> Retai 1 Sal es - Scattergoods I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIPTIONOFGROPERTY�SMOWBEIOWORATfACMFOURCOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or4 e�ocK 612 oF Rucker's First Plat GOVERNING 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 AUTHGRITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMA�CE OF CONSTRUCTION. <br /> JOB AODRESS SIGNRTURE O NTRnGtOF iHOfi12ED FGENT OniE <br /> 2609 Colb Avenue �' <br /> PLUMBINO ME NICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> i WATERCLOSET�TOILEn AIR COND.UNITS- H.P.EA. <br /> BATHTUB REFRIGERATION UNITS- M.P. EA. <br /> LAVATOflY(WASH BASIN� BGLERS - M.P. EA. <br />� SNOWER GAS FIRED A.C.UNITS- TCNNAGE EA. <br /> KITCMEN SINK 8 DISP. FOflf,E�AIR SYSTEMS- B ..U. M EA. <br /> UISHWASHER WALI.MEAiERS- B.T.U. M <br /> LAUNDRV TFAY UNIT HEATERS- B.T.U. M <br /> CLOTHES WASMEF EVAPORATIVE COOLERS <br />� � i WATER HEATER CLOTMES DRVERS <br /> I ' I URINAL VENTIL4TION FAN <br /> DRIhKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR MAYDLING UNIT - QF.M. <br /> VACUUM eREAKERS STO�'E-W000 <br /> ROOF DRFINS- PAINLEADERS METFL FIREPLACE 8 CMIMNEY <br /> SINK�SERVICE- BAR, ETC.) FIREPLACE INSEflT <br />' HEAT PUMP <br /> SUB TOTAL i SI18 TOTAI S <br /> PENMIT S PEflMIT S <br /> TOTAL FEE S 70TAL FEE S <br /> SIDE YARD:iETBACK STtiEET SETDACK REAR YARD SEiBACK PLAN CHF.CK NUMBER PLAN CHECN FEE <br /> 84/13515 FEE110.83 6989�CEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> : '�.YES i!NO FEES VALUA710N FEE <br /> TYPE OF CONST. OCCUPANGY GROUP NO.OF DWELLING UNITS <br /> BUIL�ING t25�Q��. �]Q 5� <br /> SI2E Gr BIDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIFED <br /> � YES �"-:NO <br /> APPNOVALS BY UATE OTHER <br /> 1.ENVIRONMENTAL CNECK UST PENALTY U.B.C. <br /> SEC.9031a) <br /> 2.BUILDING PLANS TOTAL ��O 5O <br /> 3.FIRE HYDRANT <br /> d.FIRE PROTECTION SVS7EM PEPMIT VALIOA710N <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN THIQ$PACE)THIS�IS�YOIIa P�NIT �� <br /> I J J I �) <br /> 6.DRAINAGE � <br /> ��� <br /> 7.ENVIRONMENTALIMPACTSTATEMENT <br /> i'�; <br /> B.HEALTHDISTRICT �, ����` �� i�� I `• • <br /> APPLICATION ACC.BY PLAN7 CHECKED 8Y APPR. FOR ISSUANCE BY <br /> � . . _ i� <br /> stg hivm lc <br /> : n 1.�� o �l . <br /> ADDR[SS FILE <br />