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theCvergr��eii - � �A'������lOe, — • - . <br />Ciiv O� �v IV <br />everet� ���,y''� PERMIT NO.OHHHO <br />CITV HAL1259�8745 <br />[VERETT, WA 98201 ❑ COMBINATION Q BUILUING ❑ M'cCHANICAL ❑ pLUMBING <br />OtVNER IdAILAD�RE55 CIiY ZIP PMONE <br />Exxon USA P,O. Box 3527 Bellevue, {Va. 98009 <br />ARCHIiECTORDE5IGNER IAAILAf10RE5S CITY ZIP PMONE <br />GENEHFLG04iRACTOR lAAILADORES$ CIiV ZIP PMONE LICENSEY <br />S. & S Sign Company 13190 Stone Ave. N. Sea cle 98133 365-0292 <br />IAE�HANICAL CONTflACTOR MAIL q�DflE55 diY ZIP PHONE UCENSE / <br />PL�IdBINGCONiflAGTOR MAILAOORESS CIiY ZIP PHONE LICENSE� <br />❑NEW ❑ADDITION ❑A�TEFATION ❑REPAIR ❑DEMOLITION ❑FENCE �IGN ❑GARAGE <br />UFiION OF WORK <br />5 �.%OQ. �� <br />erect illuminated sign <br />OSED USE OF �UIl01NG <br />LEG�I DEoCRIFiION OF PROPERTY �SNOVJ BELOIY OF /TTACH FOUR LOPIES� <br />LOi BLOC�OF <br />�oenooaess <br />8902 Evergreen Way <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />WATEfi CLOSET (TOILET) <br />_ �BATHTUB <br />Ll.JATORY �WASH BRSIN� <br />SHO�'JER <br />KITCH:.N SINK 8 DI:P. <br />�!SHV,'ASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATEfi HEATER <br />URINAL <br />DRINKING fOUNTAIN <br />FLpOF �RAIN <br />VACWh1 BREAKERS <br />ROOF ORAINS — RAINLEADERS <br />SINK ISERVICE — BAH, ETC.) <br />SUBTOTAL <br />PERMIT <br />SIDE YFlRD SETPACK <br />USE ZONE <br />dIZE OP BLDG. <br />STP.cCi SETBACK <br />OCCUPANCY GROUP <br />t. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />� FIPE HYDRANT <br />4. FIFE PRO7ECTION SYSTEM <br />5. GRADID:G <br />6. DRAINAGE <br />7. ENVIRONIdENTAL IMPAC7 STATEh1ENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />FEE <br />REAR YARD SETI <br />VACANT SITE <br />❑YES uN0 <br />NO.OF OWELLIN <br />MAX.00C.LOAD <br />FIRE SPRINKLER; <br />REOUIRED <br />❑�YES �❑NO <br />BY I �A7E <br />APPR.FORISSUANCE 8Y <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TFIE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE GF WORK WILL BE COMPLIED V.iTH WHETHER SPECIFIED <br />HEfiEIN OR NOT. THE GRANTIflG OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONST9UCTION OR THE FERFORMANCE OF CONSTRUCTION. <br />SIGNFTUFE OF COtITFACTOR OR AUTHOF2ED PGENT OATE <br />X Check �,2331 1/13/81 <br />MECHANICAL <br />TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFqIGEFATION UNIiS — HP. EA <br />cna — n.r. t/+. <br />FIRED A(:. UNITS — TONN�GE EA. <br />:ED AIR SYSTEh1S — B.T.G. M <br />. HEATERS — B.T.U. M <br />HEATERS — B.T.U. M <br />VENTILAiION <br />AIR HANDLING UNIT — GP.M. <br />NUAIBER <br />BUILDING <br />PLUMPING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />FEE <br />PEE I RECEIPT NO. <br />S 1i00 <br />LLB.C. <br />SEC.3D3(a) <br />��� <br />� ora� I I 9 I 0 0 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDA7ED QN THIS SPJIG�C) �HIS IS S�CPUF�l�71.� f� __ � <br />� <br />:xi <br />. "':..,,,.If'r� <br />,. �:: , U � <br />ADDRESS FILE <br />� ; I�E3 �� I <br />/i <br />�h <br />