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rhr E��er.e�een <br />��ir�� <br />everett <br />CIT'f HALL 259�8745 <br />EVERE7T, WA 98207 <br />� �ONSTRUCTIC�y <br />PERMIT <br />❑ COMBINATION � BUILDING ❑ MFCHANICAL <br />PERMIT NO. 12591 <br />❑ PLUMBING <br />OWkER MARA008ESS CIiY ZIP PHONE <br />Underhill's FVrr.iture 6020 Evergreen Way Everett 355-1960 <br />O.RCNITEGT Ofl UESIGNEF MAIL ADOFE55 GITY ZIP PHONE <br />GENERNL CONTRFGTOH �,1AIL AOpflESS QTY ZIP PHONE LILENSE / <br />Simco Sign Co. P.O. Box 68 Everett 98206 252-0086 <br />MEGMFNICRL CONTRAGiOR MNIL qDOflESS LITY ZIP PHONE LILENSE M <br />PLUMBING CANTRACTOR MpIL A��RE55 CITY ZIP PMONE LICENSE M <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR D DEMOLITION ❑ FENCE }� SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />\'AIUATION OF WORK <br />S 3Q�.�� <br />install illuminated <br />'ROPOSEO USE OF BUILOING <br />.EGAL DESGRIPTION OF PROPERTY �51 <br />LOT_BLOGK_OF._ <br />108 ADORESS <br />6020 Evergreen Way <br />PLUMBING <br />NG. TYPE OF FIXTU <br />WA7ER CLOSET (TOILEf) <br />BATFf7U8 <br />LAVPTORY�WASHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />WATEF HEATER <br />URINAL <br />DRINKING FOUPITAIN <br />FLOOR DRAIN <br />VACUUM BREAI(ERS <br />ROOF DRAINS — fiAINLEADERS <br />SINK ISE9VICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTl�L FEE <br />OF BLDG. I NO. <br />APPHOVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDIMG PLANS <br />3. FIRE HVORAN7 <br />�i. FIRE PROTECTION SYS7EM <br />5. GRADING <br />6. �RAINAGE <br />7.ENVIRONMENTALIMPACTSTAT <br />B. HEALTH DISTRIC7 <br />� <br />S <br />S <br />5 <br />]YES CiNO <br />MAX.00C.LOAD <br />� <br />NV <br />I HEREBY CEqT!�Y THAT I HAVE READ AND EXAMINED THIS <br />APPLICATIOr: AND KNOW THE SAME TO BE TRUE AND <br />�ORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERIJING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT COES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />Ofi CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW�.jiEGUJ.lCj';NG CONSTRUCTION OR THE <br />PERFORMktT�E OFiG`Op�STRJCTION. <br />Al1TMOfli7.E0 AGENT DATE <br />A--'� 10/19/63 <br />NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIREO A.C. UNITS — 70NNAGE EA. <br />FORCED AIR SYS7EM5 — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UtJIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLEflS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />hIR HANDLING UNIT — QF.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLhCEINSERT <br />HtAi PUMP <br />SUB TOTAL S <br />PEHMIT S <br />TOTAL FEE S <br />( NUMEER PLAN CI <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />S <br />FEE <br />RECEIPT NO. <br />FEE <br />��� <br />��� <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED pN THI jS3 7� THIS � x0}�RIPEqhryT__i ��I . <br />I)O] UU � <br />1• <br />gY Y�:.�l!R RECEIPT-.�� <br />-;_tr,,,NK YOU <br />ADDRFSS FILE <br />2 2 GCT 8 3 <br />