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� nc� L�'Cr,�rcen -� ' -�pNSTRUCTIO��� <br /> ��1�oF r <br /> everett PERMlT PERMIT N0. 12777 <br /> GITY HALL 259�Bi45 <br /> EVERETf,VJA9B207 ❑ COMBINATION t�7 BUILDiNG ❑ MECHANICAL ❑ PLUMBING <br /> GITY ZIP PHONE <br /> OW NER MFIL ADDRE55 ^ <br /> 5615 Evergreen Way Everett 98204 _ <br /> City Bank �iTy ZiP VMONE <br /> ARGHI7ECT OR�ESIGNER MAIL AOOFE55 <br /> CI7Y ZL� PNUNE LICENSE M <br /> GENERAL GONTRACTOR MAIL ADORESS p �J,6-8835 <br /> Herry Neon Co. Inc. 21027 61st West Lynnwood <br /> 8036 ' <br /> MEGHANICAL CONTPACTOR MAIL AD�RESS <br /> GTV ZIP PHONE LICENSE 1 <br /> BERRYN247LD <br /> � CRV ZIP PHONE LICENSE� <br /> - PLUMBING CONTRAGTOR MAII AD�RE55 <br /> CLASS OF WORY. <br /> ❑ NEW ❑ AD�ITION O ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENi.E }I�i SIGN � WOOD SYOVFJFIREPLACE INSEfl <br /> VALUATION OF WORK <br /> S SBZ5.O� <br /> DESCRIBE WORK <br /> erect illuminnted sign <br /> PPf,FOSED USEOF BUILDING � ��{EREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO 8E TRUE AND <br /> lEGl.'_OESCR'PTION OF PROPERTV�540W BELOW OP PTTACM FOUfl COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> G9VERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT__BLOCN�OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NdT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORNANCE OF CONSTRUCTION. onre <br /> SIGNPTURE OF LONTPACTOR OR AUTHORIZEO AGENT <br /> JOB AODFESS v <br /> 5615 Evergreen Way �� <br /> MECHANICAL <br /> � PLUMBING FEE <br /> N0. TYPE OF FIXTURE OR ITEM FFE N0. TYPE OF EQUiPMENT <br /> WATERCLOSET�701LE� AIR COND.UNITS— H.P. EA. <br /> REFRIGERATION UNITS — H.P. EA. _ <br /> BATHTUB <br /> LAVATORYIWASH BASIN) � BOILERS— H.P. EA. <br /> GAS FIRED A.C.UNITS—TaNNAGE FA. <br /> SHOWER <br /> FqRGED AIR SYSTEMS— B.T.U. �A EA_ <br /> KITCHEN SINK 8 DISP. M <br /> WALL HEATEFS— B?.11. <br /> DISHVdASHER , <br /> UNIT HEATERS— B.T.U. M <br /> LAUN�RYTRAY <br /> EVAPORA7IVE COOLEPS <br /> CLOTHES W4�HER CLOTHES DRYERS <br /> WATER HEATER <br /> VENTILATION FAN <br /> - URINAL <br /> RANGEHOOD <br /> �RINKING FOl1NTA1N C.F.M. <br /> FLOOR ORAIN 1 AIR HANDLING 11NIT— <br /> -- —� STOVE—WOOD <br /> VACUUM BREAKERS <br /> ROOF ORAINS— HAINLEADEFS <br /> METAL FIREPIACE 8 CHIMNEY <br /> SINK(SERVICE — BAR,ETQ) FIREPLACEINSERT <br /> HEAT PUMP <br /> SURTOTAL S SUB TOTAL 5 <br /> PERMIT S <br /> - PEHMIT S — <br /> TOiAL FEE 5 <br /> TO7AL FEE 5 pLAN CHECK FEE <br /> SIDE YARD SETBACK STREET SETBACK REA(i YARD SETBACK PLAM1 CHEGK NUMBER FEE REGEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> :':YES .�,NO <br /> TYPE OF CONST. OCCl1PANCV GROUP NO.OF�WELLING UNITS <br /> BUILDING 5 5825. 21 00 <br /> SIZE OP BL�G. NO.OF STORIES MA%.OCQ. 1.0A0 pLUMBING <br /> � FIREZONE BASEMENT FIRE SPRINKLERS MECHANIrqL <br /> R�OUIRED � <br /> � 'YES f�.NO <br /> qppROVALS BY DATE <br /> OTHER <br /> U.B.G. <br /> t.ENVIRONMENTAL CMEGK LIST PEhAL7Y SEC.�03(a) _ <br /> 21 00 <br /> 2.BUILOING PLANS TOTAL <br /> 3.FIRE HYDRAN7 <br /> PERMIT VALI�ATION <br /> q.FIRE PROTECTION SYSTEM WHEN PROPERLY VALIDATED(IN 7H16 6PAGE)THIS�151YWP P�FiFAIL i t' <br /> S.GRADING � J d 4 U L �1 t-� <br /> 6.DRAINAGE S1�JI� to be all on private Property. No � <br /> 7.ENVIRONMENTALIMPACTSTATEMEN7 projection OVeY pUbllC right gf W8y�+r nT�� <br /> 1 rJ l.(.�1 1 <br /> 9.HEALTHDIS7RICT permitt.ed. `,�: � �� �� h.- +"'� <br /> qppLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANGE BY - �V ���^ <br /> '; 1 i;h.�. � ..: U <br /> gr NV <br /> - r,Z <br /> — I ) oEC U: <br /> ADDRESS FILE <br /> �_ - �- <br />