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fhe Evergrcen <br />CITY OP <br />everett <br />259-8745 <br />� � �''ONSTRUCTION ° � • <br />PERMIT PERMITNQ:_ � �U�! <br />❑ DEMOLI710N ❑ CQMBINATION LKJ BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEfl MAILNpOFESS ITY ZIP <br />Merv�n's 22301 Foothill Blvd. Hayward, C�1 94541 (415`�"i��/-3400 <br />ARCNITELi Ofl � IGNEP MP'� ADDRESS CITY ZIP <br />Keyes Industries, Inc. 1938 1=ourth St. San Rafael, CA 94901 (415`���/-0171 <br />GENEflAICONTRACTOR MAILADORESS CITV IIP PHONE LICENSEx <br />�c��uv� �r,bint5���ni Crnsr i�(�19� I.�v�ks �il�hf �nr �.EA�rv.c�v CA q<Is�� �ls 53or� <br />MECHANICRL CONTRAGTOR MAIL AOORE55 CITY Z P PHONE LICENSE � <br />��vl:2C I 199 f<J <br />PLUM�ING WNTRFCTOR k,AILA00RE55 CITY 21P PNONE LICENSE � <br />CLASS OF WOflN <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ �EMOLITION ❑ BUILDING RELOCATION <br />530000.00 <br />oescaiae wonK <br />Install 15 foot hiah storaae shelvin anrl ra+ialkc shelves <br />MEATSOURCE g for 6i�ger 1 evel aeee--s—�a <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />Retail <br />LOT _ BLOCN _ <br />JOB <br />5 Evergreen Way <br />PLUMBING <br />TYPE OF FIXTI <br />WATEq CLOSEi �TOILET) <br />BATHTUB <br />LAVATORV �WASH BASIN) <br />SHOWEF <br />KITCHEN SINK d DISP. <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR DflAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADE <br />SINK (SEFVICE — gAR. ETQ) <br />NA <br />V—N <br />s¢eocu�oc <br />9122 sf <br />SUBTOTAL 5 <br />PEFMIT $ <br />TOTALFEE 5 <br />�RSETBACK SIDESE <br />NA nA <br />NA <br />OCCUPANCYGR( <br />B-2 <br />2 <br />FIRESPRINKLERSREOUIRED I?SVES ❑NO _ <br />RPPUCATION ACC BY PL�NS CHECF <br />S.H. B.E <br />I HEREBY CERTIFY THAT I 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 GRANTIIJG OF A <br />PERMIT DOES NOT PRESUME TO G�VE 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 />SIGNATUR�OFCOI/jR�CTOR.f�JT/�OqIZEDNGENT.OROWNER pATE <br />X C.�p..�,� <br />MECHANICAL <br />FEE NO. TVPE OF EOUIPMENT <br />A/C — A/HNDLG UNITS — HP. <br />flEFRIGERATION Ui:175 — H.P. EA. <br />BOILERS — B.T.U./H.P. <br />GAS FIRED A�C. UNITS — B.T.U. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATEFS — B.T.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPOFATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER • <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />¢ACANT SITE <br />❑YES �`NO <br />NO OF DWELLIN[. UNITS <br />0 <br />n+ax. occ. iono <br />0 <br />AFPR FOR ISSUANCE OY <br />L.C. <br />SUB TOTAL <br />PEPN.IT <br />70TALFEE <br />PLAN CHECK NUMBEF <br />67/17677 <br />BUILDING <br />PLUMBING <br />MECNANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STA7EENERGYSURCHANGE <br />DRIVEWAY PERMIT <br />FEE <br />FEE RECEIPTNO. <br />184.92 83504 <br />VALUATION FEE <br />�aanoo�.00�z.�r enoa��:��4 so; <br />/ <br />n �n+vr � <br />ELDG °^� ,.50 <br />ru�r� :�^�e� �>.. <br />1 50 <br />TOTAL I I Z$E>IOO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THI515 VOUR PERMIT <br />L` <br />[,`• <br />�0 <br />�• <br />r� <br />AnpkLSS FlLE <br />1 <br />