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the Evergreen <br />CITY OF <br />everett <br />259-8745 <br />rONSTRUCTION <br />PERMIT <br />PERMIT NQ. 1 Q J <br />❑ DEMOLITION <br />❑ COMBINATION r] BUILDING <br />❑ MECHANICAL <br />'❑ PLUMBING :9 SIGN <br />OWNER <br />MAIL AD' .ES <br />CITY <br />ZIP PHONE <br />Safeway Stores <br />7601 Evergreen Way <br />Everett, WA 98203 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />Northwest Neon <br />& Plastic 815 8th St. <br />Kirkland, <br />WA 98033 <br />822-1200 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE <br />Same <br />m <br />NORTHNP25402 <br />MECHANICAL CONTRACTOR <br />MAILADORESS <br />CITY <br />ZIP PHONE LICENSE, <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE, <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION LN ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCArION <br />VALUATION OF WORK <br />S 8000.00 <br />Remove axisting sign from pylon and install new sign on existing pylon. <br />HEAT SOURCE <br />❑ ELECTn:^ITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Grocery - shopping center. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE P NCE INSTRUCTION. <br />SIGNAT F R TOR AUT IZED AGENT. OR OWNER DATE <br />X <br />L'=GAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ .BLOCK Of <br />JOB ADDRESS <br />7601 Evergreen Way <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — A/HNDLG UNITS — H P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY ( WASH BASIN) <br />BOILERS — B.T.U./H.P. <br />SHOWER <br />GAS FIRED A.C. UNITS — B.T.U. <br />KITCHEN SINK B DISP. <br />FORCED AIR SYSTEMS —BT.U. MEA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />$ <br />SUBTOTAL <br />PERMIT <br />S <br />PERMIT <br />TOTAL FEE <br />$ <br />TOTAL FEE <br />FRONT SETBACK <br />BEAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEI PT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />PEES <br />.VALUATION <br />FEE <br />BUILDING <br />S B000.00 <br />27 <br />00 <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />PLUMBING <br />SIZE OF SLOG. <br />NO, OF STORIES <br />MM. OOC. LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REQUIRED DYES EINO <br />INVESTIGATION FEE <br />See. 004(0) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />S.H. <br />_ <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />Elect. N.V. <br />L.N. Callahan <br />DRIVEWAY PERMIT <br />TOTAL <br />27 <br />100 <br />GFRMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />d. -3 <br />LI3 <br />07) <br />m <br />r <br />ADDRESS FILE <br />