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r <br /> 1 <br /> theErergreen --�. �ONSTRUCTIO� , � <br /> CITY OF <br /> �verett PERMIT pERMiT NO. 11331 <br /> GTY HALL 259�8745 <br /> EVERETf.WA 98201 ❑ COMBINATION xI�[BUILDING ❑ MECHANICRL ❑ PLUP.iBING <br /> OYMER MAILA�pRE55 GITY ZIP P�10NE <br /> Compu-Byte Inc 4826 Evergreen Wav Everett 98203 252�560 <br /> ARCHrtECTOR�E5IGNEF ' IAAILAD�RE55 CITY ZIP PHONE <br /> GENERPL LOIITRACTOF MAILADDRE55 CITV 21P PMONE LICENSE� <br /> Simco Sign Co. P.O. Box 66 Everett 98206 252-0086 �1 <br /> � MEGHAIlICALCANiMLTOR MAILAD�RE55 CITY 21P PMONE UGENSE� ` <br /> PLUMBINGCANTRACTOR MFILADOPESS CITV ZIP PMONE UGENSE� <br /> C1A550F WOFK <br /> ❑NEW ❑ADDITIOtJ ❑ALTEf7A710N ❑REPAIR ❑DEMOLITION ❑FENCE ]�SIGN GARAGE <br /> yALIIATION OF WORK <br /> a 774.00 <br /> �ESCRIBE WOPK <br /> Install illuminated Si n <br /> PqOPOSED USE OF DUILDING <br /> I HEREBY CERTIFI' THAT I HAVE READ AND EXAMINED THIS AP� <br /> LEGALDESLRIPTIONOFVflOPERiY15HOW BELOWORATTFCNFOUR:APIE5) PLICATION AND Y.NOW THE SAME TO 8E TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or BLGGK�OF TYPE OF WORK WI�L BE COMPLIED WITH WHETFIER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CA�ICEL THE PRO� <br /> VISIONS OF A Y OTH R STATE OF LOCAL LAW REGULATItJG <br /> CONSTRU O PERFORMANCE OFCONSTRUCTION. <br /> SIGNATUP 1TR OR AUtHORIZEDAGENT OATE p <br /> JOBA��RE55 X /�/(r0 J�� <br /> 4826 Evergreen Way <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�IIIPMENT FEE <br /> WATER CLOSEf(TOILEi� AIR COND.UNITS—H.P.EA. <br /> BA7HTUB REFRIGERATION UNITS—H.P.EA <br /> LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SHOVJER GAS FIRED A.C.UNITS—TOIJNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B T.U. M EA. <br /> DISHWASHER .IALL HEATERS—B.T.U. M <br /> LAUNDRY TRAV UNIT HEATERS—B.7.U. �� <br /> CLOTHeS WASHER EVAPORATIVE COOLERS <br /> WATEF HEATER CLO7HE5 DRYEPS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD — <br /> AIR 4ANDLING UNIT— C.F.M. <br /> FLOOR�RAIN <br /> VACUUM 9REANEflS STOVE <br /> ROOF DRAVJS—RAWLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SEflVICE—BAR,ETCJ <br /> v SUB70TAL s <br /> SUBTOTAL <br /> PEHMIT S PERMIT s <br /> TOTALFEE S TOTAtFEE S <br /> pLAN CHECK FEE <br /> SIDE YARD SETBACK STREET SETOACK REAR YAPD SETBACK PLAN CNECK 1JUMBER RcCEIP" 'JO. <br /> FEE � <br /> USE ZONE LO7 AREA VACAN7 SIT�= VALUATION FEE <br /> ❑YES ❑NO FEES <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> OUIIDING F7�q , p0 6 00 <br /> SIZE OF BL�G. NO.OF STOflIES MA%.GCQ LOAD <br /> PLUMBING <br /> � � FIP.E SPFINKLERS <br /> FIRE ZONE BASEMENT RE�JUIRED MECHFNICAL <br /> ❑'!ES �NO <br /> APPHOVALS by DATE OTHER <br /> 1. ENVIRONMENTAICHECKLIST PENALTY U.BC. <br /> SEG.309(a) <br /> 2. BUILDINGPIANS TOTAL B 00 <br /> � 3. FIRE HYDRANT <br /> � 4. FIRE PROTECTION SYSTEM PEHMIT VALIDAtION <br /> WHEN PROPERLV VALIDATED(IN 7HI5 SP IC');I�'15�'�O O O?0 0 µ�T <br /> 5. GRADING � M ' <br /> 6, DRAINAGE - � (y'� <br /> 7. ENVIRONA4EN7ALIMPACTSTATEMENT y�, {�� �ECEIPT� � <br /> 8. HEALT4 DISTRICT � � <br /> APPLICATION ACC.BY PLANS CHECKEC OY APPR.FOR ISSUANCE BY ' ' w;�t�K YQ U <br /> , . <br /> l 5 �c .$:i. . . <br /> ADDRESS FILE - - - --- � <br /> . .s <br /> � <br />