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� <br /> theEvergreen � C��ySTRUCTION ���� .� <br /> CITY OF <br /> everett ���M�T PERMIT Hf?. O91Z� <br /> CITY HALL 259�874L <br /> EVERETf,WA 98201 ❑ COMUINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OVlNER MAILADDRE55 GITY ZIP PHJNE <br /> Creative Needle 5305 Evergreen Way 98203 355-1919 <br /> ARCHIlEGi0PDE51GNER MAILADDf1E55 C�TY ZIP PHONE <br /> GENERALCANTF�CTOR MFILAD�flE55 CITY ZIP PHONE IICENSEr <br /> Berry Neon Co. Inc. 21027 61st West Lynnwood, Wa. 98036 776-6835 <br /> IAECHANICALCONiRACTOR MAILA�DflE55 CITY ZIP PHONE LICENSEI <br /> BE RR YN 247J 50 <br /> PLUTABING fANTRACTOF !AAI�A�DflE55 LITY ZIP PMONE LIGENSE 1 <br /> G1A55 OF WORK <br /> ❑NEW ❑ADOITION ❑ALTERATION ❑R[PAIR ❑DEMOLITION ❑FENCE I.��IGN ❑GARAGE <br /> VAWATION OP WOFK <br /> 8fi0. 00 <br /> DESCRI9E WORK <br /> erect illuminated sign <br /> PROPOSEU USE OF BUIL�ING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEGALDESCPIPTIONOFPROPFRIY(SHOW EFLOWOflAiTAGHFOURCAPIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> AL� PROVISIONS OF LAWS AND QRDINANCES GOVERNING THIS <br /> �or BLOCK�OF TYPE OF WORK WILL BE COMPLIED WiTH WHETHER SPEGIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIG�lATURE�CONTRFCTOR OR AUTHORRED AGENT DATE <br /> JOB AODFE55 <br /> 5305 Ever rren S9a x <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNITS—H.P.EA. <br /> BATIiTUB REFRIGERATIOIJ UNITS—H.P.EA <br /> LAVAT�JRV(WASH BASIN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED A.C.UNI7S—TONNnGE FA. <br /> KITCHEN SINK 8 Di�P. FOFCED AIR SYSTEIdS—B T.U. M EA. <br /> DISHVJASHER WALL HFATERS—B.T.LL M <br /> LAUNDRY TRAY UNIT HEATERS—B.T.U. �A <br /> CLOTHES\VASHER EVAPORATIVE COOLERS <br /> � WATEfl HEATER CLOTHES DRYERS <br /> � URINAL VENTILATION FAN <br /> t; DRINKING FOUNTAIN RANGE HOOD <br /> �� FLOOR DRAIN AIR HANDLING UNIT— ��F���� — <br /> IVACUUM BREAKERS STOVE <br /> ROOF DRAINS—flAINLEADERS 1dETAL FIREPLACE b CHIMNEY <br /> � � SINK(SERVICE—BAR,ETC.) <br /> SUBTOTAL SUBTOTAL 5 <br /> PERMIT S PEHMIT 5 <br /> 707AL FEE S TOTALFEE S <br />(� PLAN CHECK FEE <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK P�AN CHECK fNMBER FECEIPT NO. <br /> FEE <br /> USE ZONE LOT AREA VACANi SI7E FEE <br /> ❑YES GNO FEES VALUAT�ON <br /> � TYPE OF CONST. OCCUPFNCV GROl1P NO.OF DWELLING UNITS <br /> BUILDING 5 850 . 00 6 00 <br /> SIZE OF BLDG. NO.OF STORIES MAh.OCC.LOAD <br /> PLUMBING <br /> FIRE 20NE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIiiED <br /> ❑YES ❑NO <br /> APPROVALS BY DATE OTHER <br /> 7. ENVIRONMENTALCHECKLIS7 PENALN U.BC. <br /> SEC.303(a) <br /> 2. BUIL�INGPLANS 6 00 <br /> TOTAL <br /> 3. F�PE HYDRANT . <br /> 4. FIRE PROTECTIO'�SYSTEM PERMIT VALIOATION <br /> WHEN PROPERLY VALIDATt�(IN THIS SPACE)THIS IS Y(OUR!P�ERMIT (� <br /> 5. GRADING � �� / 4 .;� II �J �, Q i) — �j-� <br /> 6. UPAINAGE N <br /> � <br /> 7. ENVIRONMEN7ALIMPACTSTATEMENT <br /> .. . , . . : i �.'� � <br /> 8. HEALTH DISTRICT ' � � ' �� �� O <br /> APPLICATION ACC.BV PLANS CHECKED dY APPR.FOR ISSUANCE BY � ���'•` U <br /> xr• aas <br /> �` <br />