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L <br /> �� the Evergreen r.p�ST RU CTIO N � . � <br /> GTY OF <br /> everett PERMIT PEpp!!!T NO. 09177 <br /> CITV HALL 259�8745 � COMBINATION ��78UILDING ❑ MECHANICP�L ❑ PLUIdBING <br /> EVERETT.WA 98201 PMONE <br /> MAII.ADOflE`a`, <br /> cir. ziP <br /> OWN-p � 5200 Evergreen 41ay Everett <br /> Brien Motor S ��r� Z�p PHO��E <br /> M�.IL ApCRE55 <br /> qRLNRECT OP DESIGNEF <br /> ���, Z�p PHO��E LICENEE 1 <br /> � MAIL ADDRESS <br /> GENERFLCANTRAGiOR <br /> S � S Sign Co. 13190 :�tone Avenue North Seattle 9Z81.33 36 Ho�z4 �IGENSE� <br /> . MFIL ADDFESS <br /> EIECHAN!GAl CANTPACTOR <br /> � CITY ZIP PHONE UCENSE 1 <br /> MAIL ADDRESS <br /> PLUTABING GONTRACTOF <br /> C1A55 OF WORK <br /> , �ryEy,� ❑ADDITION ❑ALTERATION ❑F7EPAIR ❑�EMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> ' VALUATION OF YJORK <br /> s 12��. �� <br /> � DESCFI�PE YlORK <br /> install illuminated sign <br /> PPOPOSEOUSEOFBUILDING I HEREBY CERTIFY THAT � HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SP.ME TO BE TRUE AND CORRECT. <br /> LEGAL DESCFIPTION OF PRGPERTV(SHOW OELOW OR ARFCM FOIIP COPIES) ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> HERE NFOR NOT11 THEEGRANTING OF A PERM TRDOESI NOT <br /> �'�. LOT BLOCK�OF <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> - CON�STRUOCTION OR TrHE PERFORMANCOE OF CO ST UCT ONING <br /> �' SIGN� R jO/FGONTRq(�tO�R�O AUTHO?�ZcDAG�ENi <br /> DA7E <br /> JOBADDRL55 X/_[ ``/'_�/ "� ,� / /I �I�27IBI. <br /> 5200 Evergreen Way � <br /> ' . MECHANICAL <br /> PLUMBING 7YpE OF EQUIPIdENT FEE <br /> FEE NO. <br /> N0. TYPE OF FIXTURE OR ITEM q�R COND.UNITS—H.P.EA. <br /> WAiER CLOSET(TOILEn qEFRIGEPATION UNIiS—H.P.EA <br /> BATHTUB BOILfRS—H.P.EA. <br /> LAVATORY(WASH BASIN) GAS FlRED AL.UNITS—TJNNAGE EA. <br /> SHOWER FORCED AIR SYSTEMS—B T.U. M EA. <br /> KITCHEN SINK 8 DISP. �yqLL HEATEFiS—BT.U. M <br /> DISHWASHER UNIT HEATERS—�6.T.U. M <br /> LAUNORY TRAY EVAPORATIVE COOLERS <br /> ' CLOTHESYlASHER CLOTHES DRYERS . <br /> WhTEfl HEATER yENT1UITION FAN <br /> URINAL pANGE HOOD <br /> DRINKING FOUNTAIN qIR HAIJDLING UNIT— C.F.M. <br /> FLCOR OFlAIN � STOVE <br /> VACUUM BFEAKEFS METAL FIREPLACE g CHIMNEY <br /> ROOF DRAINS—RAINL'eNDERS <br /> SINK(SERVICF—BAF.ETQ) <br /> __� SUB T�DTAL 5 <br /> SUB TOTAL pEFlMVT S <br /> PEPMIT s 707A1.FEE S <br /> TOTAL FEE S PI.l�N CHECK FEE <br /> SIDE YAR�SETBAGK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUM�ER FEE RECEIPT NO. <br /> L��ApEq VACANT SITE FEES VALUATION FEE <br /> USEZONE pyES ❑NO <br /> NPE OF CON57. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING � 1200 . 00 9 00 <br /> SIZE OF BLDG. N�.OF STORIES MA%.OCC.laAO <br /> PLUMBING <br /> BASEMENT FIRESPFINKLERS MeCHAhI�4L <br /> FIRE ZONE REOUIRED <br /> ❑YES ❑NO <br /> 3Y pATE O7HER <br /> APPflOVALS <br /> PENALTY U.B.C. <br /> 1. ENVIRONMENTAL CHECK LIST SEC.303(a) <br /> g 00 <br /> 2. BUILDINGNV+NS TOTAL <br /> 3. FIRE HYDRANT pEFlMIT VALIUATION <br /> 4. FIRE PFOTECTION SYSTEM WHEN PROPERLY VALI�ATED(IN THIS SPACE)THIS IS C UR PEqPMIT(� <br /> S. GRADING Sign to be all on� private��'rb'P�e'tty. � <br /> 6. DRAINAGE � <br /> 7. ENVIROktdEN7AL IMPACT STATEMENT . . � �' " �, I n I � <br /> � . i� . .� Q <br /> B, HEALTHUISTRICT � � v �• �� �J <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR 1591/ANCE Bi .. <br /> ! .. i . <br /> , � „ia UI <br /> ADDRE55 FILE <br />