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fhe Euergreen <br />CITY OF <br />ev�e.ret� <br />259-8745 <br />� ; t��71�STRUCTIOIV � � p <br />PERMIT PERMITNQ:=�� U��� <br />❑ DEMOLITION ❑ CJMBINATION ❑ BUILDING �1 MECHANICAL $� PLUMBING ❑ SIGN <br />OWNEfi MAILADDRC55 CITY 21P PMONE <br />2dbtxSa�xcr+�c Volume Shoes 7601 Evergreen Way #G2 Everett, WA 98203 <br />rl(iCHITECTORpE51GNER IARIL�ODRE55 CITY ZIP PNONE <br />GENEflAICONTRFGTOR MMLPODRE55 CITY ZIP PHONE LICENSE+ <br />Commercial Structures Inc. P.O. Box 68843 Seattle, WA 98168 246-3939 <br />MECMhNICALCONTFACTOR MAILADORESS CITY ZIP PMONE LiCENSE• <br />PVJM�INGCOkiRACTOfl MAILAOOFE55 CItY ZIP PMONE IICENSEo <br />Northwest Energy Systmes 20815 52nd Ave W. Lynnwood, WA 98036 774-2980 NORTHE5142 <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RF.LOCATION <br />5 <br />oescnioe wonk <br />Install water heater, lav, toilet & drink fountain <br />HEATSOURGE <br />❑ ELECTHICITY ❑ GAS ❑ WOODSTOVE O OTHEF <br />Retail <br />.EGRL OESCfiIPT10N OF PROPERTY �SMOW DELON <br />�or _ a�ocK _ oF <br />oonooaess <br />760_ Evergreen Way E-2 <br />PLUMBING <br />WATER CLOSET (TOILET) <br />BATHTUB <br />L,IVATORV (WASH �ASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDflVTRAV <br />CLOTHES WASHER <br />URINFI <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKfLOW PREVENTERS <br />ROOF DRAINS - FAINLEADEAS <br />SINK �SERVICE - BAR, ETC.) <br />kDlY�1� <br />APPLICATIONACC �Y <br />M.hf. <br />SUBTOTAL <br />PEFMIT <br />TOTAL FEc <br />fiEAF SETOACN <br />Lf T AREA <br />OCCUPANCYGROUf <br />N0. OF STORIES <br />i ❑ VES ❑ NO <br />PLANS CHECNED BY <br />FEE <br />Si�E SET04CN <br />VFCANT SITE <br />❑YES ❑NO <br />NO OF ONELLING UNITS <br />hl�% JCC LOAD <br />APPP FOR ISSUFNLE OY <br />I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNIPIG THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRAN7ING OF A <br />PERMIT DOES NC�T PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUfVEOFWNTRACTOR.AU HOR. DAGENT.OROWN[R DAtE <br />.n ..l� . �� � �n q . � . . . !1 --� <br />VO. TYPE OF EOUIPMENT <br />A/C —A/HNDLG UNITS — HP. <br />REFRIGERATION UNITS — H.P EA. <br />BOILERS — B.TLJN.P. <br />GAS fIPEO A.G UNITS — B.T.U. <br />FORCED AIP SYSTEMS — BS.U. M EA. <br />WALL HEATERS — B T.U. M11 <br />UNIT HEATERS — D.T.i' N. <br />EVAPORATIVECOOLERS <br />CLOTHES DRYEfiS <br />VENTILATION FAN <br />' RANGEHO00 <br />1 WATER HEATER • <br />WOODSTOVE <br />hIETAI FIREPLACE L CHIMNEY <br />iIREPLACEINSERT <br />HEnT PUMP <br />GAS PIPING <br />E%H�USTFAN <br />PLAN CHECK NUMBER <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANiCAL <br />INVESTIGATION FEE <br />SUBTOTAL 3 v au <br />PEfiMll' S ' — <br />TOTAL iEE 5 � <br />FEE RECEIPT NO. <br />,UVACUATIOt1cr� :�e. i'�.0_1;fiE�17� -;:I�..`:';. <br />S <br />.i����_�:._� <br />STATE BUILOING SURCHARG <br />STA7EENERGVSUFCHARGE <br />DRIVEWAYPERMIT <br />TOTAL <br />.i't_i,y�'i '�l,�.'�l <br />PERMIT VALIDATION <br />WHEN PROPERLV VALIDATED �IN THIS SPACE) THIS IS VOUR PERMIT <br />ni rr,Fs� „ _ <br />25 00 <br />6 50 <br />31 <br />