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the Evergrecn <br />cin oF <br />everett <br />259-8745 <br />t'rJNSTRUCTI�N - <br />PERMIT <br />PERAAIT NQ: - � � � � 6 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL '❑ PLUMBING Q SIGN <br />OWNEN M�ILAODRE55 CITY 21P PIiONE <br />Evergreen Campus Plaza 7815 Evergreen Way Everett, WA 98203 <br />........���...oncc�nucv h1AILF�DFE55 CITY 21P PHONE <br />GENEflAI LONTRAGTOR MAIL AODRE55 CRY ZIP PMONE UCENSE • <br />National Sign Corp. 1255 Westlake N. Seattle, WA 98109 282-0700 <br />MECHFNICALCONTRACTOR MAILA�O(iE55 CITY 21P PHONE LICENSEn <br />NATIOSC*166MS <br />�NEW ❑ ADUITION <br />MAIL <br />❑ ALTERATION ❑ REPAIR ❑ DEMOLITION <br />S 8000.00 <br />DESCRIBE WORN <br />2nstall and maintain one D/F sign all on private property. <br />HEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOOUSTOVE ❑ OTHER <br />il <br />LOT � BLOCK _ <br />PLUMB�NG <br />N0. TYPE OF FI) <br />WATEF CLOSET (TOILI <br />BATHTLB <br />LAVATORV�WASHBA: <br />SHOIVER <br />Kf�CHEN SINK fl DISP. <br />�ISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASMER <br />URINAL <br />ORINKINti FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTE <br />ROOF ORAINS — PAINI <br />SINK (SERVICE — BAR, <br />SUBTOTAL <br />PEflM1T <br />TOTALFEE <br />lOT AREA <br />1'YPE <br />PHONE UCENSE• <br />❑ BUIIDING RELOCATION <br />I�iEREBY CERTIFY THAT I HAVE READ AND EXAMINED ThIIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS ANC ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTItdG OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE� R LOCAL LAW REGULATING CONSTRUCTION OR <br />THE P FOj.��fiNCE OF CONSyTRl1�J�N—, <br />,.........� ..�,J�.onnmo �avct5A6ENLOFOWNER� DATE <br />X� ��T� <br />MECHANICAL <br />NO. TYPE OF EQUIPME <br />A/C —lvHNDLG UNITS — H.P. <br />RFFRIc;Fa4l'ION L1�JITS — H.P. EA. <br />BOILERS — O.T.U./H.P. <br />GAS �IRED A�C. UNITS — B T.U. <br />FORCEDAIRSVSTEMS—BT.U, MEA. <br />WALL HEATERS — B.T.U. M <br />UNITHEATEHS—B.T.LL M <br />EVAPORATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOU <br />WATEF HEATER • <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HE�T PUMP <br />C 5 PIPING <br />E%HAUSTFAN <br />PLAN CHECK <br />VACANi SIT[ FEES <br />❑YES C]NO <br />NO.OFD\YELLINGIINITS BUILDING <br />PLUMBING <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />Fi <br />SIZE OF �IDG. I NO OF STORIES I MA%. OCG LOFD _ <br />MECHANICAL <br />PLANS CHECKE� OY <br />S.H. <br />4PPfl FORISSUANCEDV <br />Elec. N.'J. <br />L.N. Callahe <br />Sign to be all on Sf�dX��IHffiX�4lt��4�xif�t <br />private property. <br />IVVESTIGATIONFEF. Sea�304(e�• <br />S(ATE BUILDING SUFlCHARGE � - �- . <br />STATEENERGYSURCHAPGE _ <br />DRIVEWAY PEFiM1T <br />TOTAL <br />RECEIPT <br />FEE <br />WHEN PROPERLY VALIOATED (IN THIu SP4CE) THIS IS VOUR PERMIT <br />AUf„�E55 f-IL� <br />�' <br />M <br />N <br />Q� <br />� <br />