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, � � • <br /> `,'�``��s��oF '- CC�'�JSTRUCTION � <br /> _ �- <br /> ��1���� PERl1111T pERMIT N0. 0�234 <br /> C6TY HALL 259�9745 <br /> EVERET7,1VA 98201 ❑ COMBINATION ❑ BUILDSNG I7�MECHANICAL ❑ PLUMBING <br /> OWNEP MAtLADDRE55 GRY ZII' PHONL <br /> Seattla First National Bank <br /> APCMITECTCR�ESIGN[R MAILADDRESS CITY ZIP PHONE <br /> GENERALrONTRFCTOR MAILA��RE55 CITV ZIP PNONE UGENSEI <br /> IdECHAI:IG4�fphTRACfOR MAILAD�RESS CRY 21P PMONE LICENSEI <br /> Holiday Parts Fab-Inc. 401 S. Webster Seattle 98108 763-8500 <br /> PLOMBINGCONiRACTON AIAILADDflESS CITY 21P PHONE LICENSE� <br /> fi0 LA DP F 376N0 <br /> CU15S OF WOHN <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATIOI:OF WOFK <br /> E <br /> DESCflIOE WOFN <br /> PFOPGSED USE Of BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEC+AlDESCRIPTIONOFPflOPERN�SHOW BELOWOPATfACHFOURCAPIES) PLICATION AND KNOW THE SA�b�.,_ 1�0 BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDiNANCES GOVERNING THIS <br /> �oT BLOCI(_OF TYPE OF WORK WILL BE COMPI.IED WiTH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRA�TING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PRO- <br /> VISIONS OF �NY OTHER STATE OR LOCAL LAW REGULATING <br /> 5019 Evergreen Way CONSTRUCTION OR THE PERFORMANC[OF CONSTRUCTION. <br /> JOB ADORE55 SIGNAT E OF CONTRACTOR Ofi UTMOFIZED AGENT DATE <br /> X % ,�. �r� <br /> PLUMBING M�ECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEH CLOSET(TOILET) AIR COND.UNITS—H.P.EA. <br /> BATHiUB REFFIGERATION UNITS—H.P.EA <br /> LAVA70RY(WASFi BASIN) BOILERS—H.P.EA. <br /> SHOK'ER GAS FIRED A.C.UNITS—TONNA3E EA. <br /> KI7CHEN SINK 8 DISP. fORCED AIR SYSTEMS—B.T.U. M El�. <br /> DISHWASHER WALL HEATERS—B.T.U. M <br /> � LAUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS 6 00 <br /> WATER HEATeR CLOTHES DRVERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DFAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKEFS STOVE <br /> ROOF DRAINS—RAINLEADERS MEfAI FIflEPLACE 8 CHIMNEY <br /> SINK ISERVICE—BAR.ETC.) <br /> SUB TOTAL SUB TOTAL 5 12 00 <br /> PENMIT S PEHMIT S 3 00 <br /> TOTAL FEE S TOTAL FEE S 15 00 <br /> SIDE YARD SETBACK STREE?SETBACK REAR YARD SEfBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECFIPT NO. <br /> 115E ZONE LOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CON57. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.lOAD <br /> PLUtABING <br /> FIRE ZONE BASEN:ENT FIRE SPnINKLERS <br /> REOI!IRED MECHANICAL 1S 00 <br /> OYES ❑NO <br /> APPHOVALS BY DATE OTHER <br /> 1. ENVIRONMENTP.LCHECKLIST PENALTY U.B.C. <br /> 2. BUILDING PLANS SEC.303(a) <br /> 3. FIRE HYORANT T�TA� 1S 00 <br /> 4. FI(7E PROTEC710N SYSTEM PEHMIT VALIOATION <br /> — WHEN PROPERLY VALI�ATED(IN THIS SPACE)THIS IS YOUR PcRM1T <br /> 5. GRADING <br /> 6. DRAINAGE 8 7 5 3� S O I 5. O � —('�)y ! <br /> 7. ENVIRONMENTALIMPACTSTATEMENT , , N' a <br /> . <br /> B. HEALTH DISTRICT ] �� i • • � � <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.POR ISSUANCE�Y 1�0 U�R R E G E f PP <br /> x.c. �f-IANK YOU <br /> ADDRE55 FILE 2 5 FEB �O <br /> � <br />