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�heErCgvee�n r_ - �ONSTRIJCTIO[ , <br /> everett PERIIAIT PERMIT NO. �-Z166 <br /> CITY HALL 259�8745 <br /> EVERET7,NlA98207 ❑ COMBINATION ❑ BUILDING C-'xX MECHANICAL ❑ PLUMBING <br /> OWNER MAIL ADDPE55 CRY ZiP PHONE � <br /> Jo Ann Fabrics 5303 Evergreen Way Everett 98203 <br /> AFiGHITELT OR OESIGNER MAIL ADCRE55 CITY Z�P PHONE <br /> GENEFAL CONTRACTOR M1�A�L AUORE55 CI7Y ZIP PHONE LILENSE M <br /> MEGHAHIGALCONTRAGTOR MAILPDOflE55 ��TY Z�P 98033 �HONE LICENSEM <br /> _ _ Sel-Kirk Htg. & Service Inc. 11833 124th Avenue N.E. Kirkland, 823 2777 <br /> ' PLUMBING COtRFACTOR M11AIL ADOfiE55 LIN ZIP PNONE LICENSE� <br /> CLASS OF WORK <br /> ❑ NEW ❑ ADOITION ❑ ALTERATION ❑REPAIR O DEMOLITION ❑ FENCE ❑ SIGN ❑ W000 STOVFJFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S <br /> �ESCRIBE WOflN <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CEflTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW lHE SAME TO BE TRUE AND <br /> IEGALJESGHIFr101JOFPROPEHTY�SHOWBELOWOPATTACHFOURLOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT_BLOCK_OF 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 STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB AO�FESS SIGNATUNE OF CONTRACTOR Ofl AUTHOfli2ED AGENT DATE <br /> 5303 Evergreen Way X 7 6 63 <br /> PLUMESING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET�TOILET) 2 AIR COND. UNITS— H.P. EA. <br /> BAT;iTUB REFRIGERATION UNITS— H.P. EA. <br /> IAV!•':1RY(WASH BASIN) BOILERS— H.P.EA. _ <br /> SHOWEiI GAS FIRED A.C.UNITS—TONNAGE EA. _ <br /> KITCHEI�SINK 8 DISP. FORCED AIR SVSTEMS— B.T.U. M EA, <br /> OISHWASHER WAIL HEA7ER5—L T.U. M <br /> LAUNURY TRAV UNIT HEATEPS— B.T.U. M <br /> CLOTHES WASHcp EVAPORATIVE COOLERS <br /> WAiEFiHEATER CLOTHES DRYERS <br /> URINAL VENTILA710N FAN <br /> DRINKING FOU�7AIN (lANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOU <br /> ROOF DRAINS— RAINLEADERS METAi FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR,ETC.) FIREPL�.CE INSERT <br /> HEAT PUMP <br /> SUB TOTAL 5 SUB TOTAL S 12 00 <br /> PERMIT 5 PEPMIT 5 10 JO <br /> TOTAL FEE S TOTAL FEE S 2 00 <br /> SIDE YARD SETBACK S7qEET SETBACK REAP YARD SET�ACK PLAN GHECK Nl1MBER PLAN GHECK FEE <br /> FEC- REGEIPT NO. <br /> USE ZONE LOT ARCA �ACANT SITE FEES VALUATION FF� <br /> I-�.YES �_1N0 <br /> TYPE OF CONST. OCGUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILOING $ <br /> 512E OF BLDG. NO.OF STORIES MA%.OCC. LOAO <br /> PLUMBING <br /> FIREZONE BASEMEN7 FIRESPRINKLERS MECHANICAL 22 00 <br /> PEOUIRED <br /> � ::��.YES ��NO <br /> APPRDVALS BY DA7E OTHEA <br /> t.ENVIRONMENTAL GHECI<LIS7 PENALT" U.B.C. <br /> SEC.903 la) <br /> 2.BUIIDING PLANS TpTA� 2 2 00 <br /> 3.FIRE HVDRANT — <br /> 4.FIRE PROTECTION SYSTEIrI PERMIT VALIDATION I <br /> 5.GRA�WG WHENPROPERLYVALIDATED(INTH18S9P8AC�E�THI�I�YQUp-P�F�.11T (,Q , <br /> L 1 U ;� <br /> 6.OFAINAGE � t—{ <br /> 7.ENVIPONMENTALIMPACTSTATEMENT .(V <br /> B.HEALTHOISTRICT �YOU (� RECEIP� � <br /> APPUCATION ACC. BY PI.ANS CHECKEO BY APPR.FJR ISSUANCE BY . <br /> i(-1,'��!!; YO U <br /> - 3 ,n�. 8 3 <br /> I <br /> ADDRESS FILE <br /> �_ - <br />