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rlie £cer,�reer <br />c�rv o� <br />�- e�ver�tt <br />CITY HALL 259�8745 <br />� " �:O���Ri��±���r� <br />R�RMIT PERMlT NO. �-580� <br />EVERETT, WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />04YNER ��AILFDDRE55 GITY Zlo PMONE <br />Everett S}:i Shop 6400 Evergreen Way Everett 98203 353-6628 <br />APCHITECT OF OESIGNEN �•�A�L ADDRE55 CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL AOORESS CITY ZIP PMONE LICENSE X <br />City Sign Service 4817 Evergreen S9ay Everett 98203 339-2644 <br />MEGMANICAL CONTRACTOR MAIL ADORE55 QTY ZIV PMONE LIGENSE N <br />CITY55158DK <br />PLUMBING CONTRACTOR MAIL AOOFESS CITY ZIP PHONE IICENSE � <br />��V' YYV ^ O NEW O ADDITION ❑ ALTERATION ❑ RFpqIR ❑ DEMOLITION ❑ FENCE �LSIGN ❑ WOOD STOVEIFIREPLACE INSER7 <br />.UATION OF WORI( <br />S %��.�� <br />install reader boazd <br />LOT_9LOCK <br />6400 Evergreen Way <br />PLUMBING <br />TYPE OF FIXTURE <br />WATER CLOSE7 ( � OI LEn <br />BATHTUB <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHEF <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />707AL FEE <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8, HEAL7H DISTRICT <br />APPLICATION ACC. BY PLANS CHE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />COPIES) CORRECT. ALL PROVIuIONS OF LAWS AP!D ORDINA�CES <br />GOVERNING THIS TYPE OF N/ORK WILL BE COMPLIED WITH <br />WH�THER SPECIFIED HEREIN Ofl NOT. THE GRANTING OF A <br />PEAMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE <br />OR CANCEL TFiE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMA CONS �RUCTION. <br />SIGNATURE �J/�f��" �� HOFIZED AGENT OATFJ <br />x /..I���i�� %.t,�--- i���4� <br />FEE NO. TYPE OF EOUIPMENT FEE <br />AIR COND. UNfTS — H.P. EA. <br />REFRIGERA710N UNITS — H.P. EA. <br />801LEFl5 — H.P. EA. <br />GAS FIRED A.C. 11�ITS — 70NNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WAIL HEATERS — B.T.U. M <br />UNIT HEA7ER5 — B.7.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />� <br />5 <br />5 <br />REAR VARD S <br />VACANT SITE <br />_YES CNO <br />NO. OF DVJEL <br />MAX. OCC. lC <br />FIRE SPFINKL <br />REOUIFED <br />":YES ..�,NO <br />BY <br />a. FOR ISSUANCE BY <br />NV/LC 12 11 E <br />CHECK <br />SUB 70TAL 3 <br />PEPMIT S <br />TO7ALFEE 5 <br />FEE I RECEIPT NO. <br />FEES VALUATION � FEE <br />eui�oiN� 5 700.Q0 5 00 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY U.B.G. <br />SEC. 307 (:.) <br />TOTAL I I S I 00 <br />WH NI PROPIEflLYO ALIDATED QN THIS�SPAaE) THI�I�J1�1S�1 ��v11I— LdT�� <br />�� <br />a, <br />� " ; R':�:; ;; i �n <br />� . �.i.'.�''��. � �.: �� <br />ADDRESS FILE <br />� 7 i''-� u J <br />z <br />0 <br />-i <br />� <br />m <br />.. .. <br />-{ T <br />... -� <br />`" m <br />00 <br />mo <br />� <br />om <br />-i z <br />x -i <br />m <br />.o z <br />c <br />a -i <br />rx <br />.r <br />-� N <br />� <br />� <br />o .� <br />�'1 D <br />3 <br />-� m <br />x <br />m� <br />N <br />O <br />om <br />C N <br />3 � <br />zn <br />.i m <br />D <br />P <br />�--I <br />2 <br />n <br />z <br />-�-I <br />2 <br />i--i <br />N <br />Z <br />O <br />--I <br />f"i <br />m <br />