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,,,�. �,�.;Y`'G4' �r�_ , CONSTRUCT��N <br /> �,� <br /> everett PERMIT PERMIT NO. �-5� b2 <br /> CITY M4LL 2S9�B745 <br /> EVERETT,WA 98201 [� COMBINATION � BUILDING CI MECHANICAL ❑ PLUMBING <br /> O'NNER MAIL ADDRE55 CITY ZIP PMONE <br /> Pay N Pak 10115 Evergreen Way E!�erett <br /> AflCNITECT OR DFSIGNEF MAIL ADORE55 Cf7Y ZIP PHONE <br /> GENERAL C TRACTOR MAIL A��RE55 CITV ZIP PH011E LICENSE N <br /> Heag�h N.W. inc. 11805 N.E. 116th Kirkland 98034 623-3100 <br /> MECMANICAL GONTRqGTOR MAIL A�ORE55 CIiY ZIP PMONE LICENSE M <br /> HEATHN*330RJ <br /> i'LUMbING CONTRACTOfl MAIL AODRESS GTY ZIP PNONE IICENSE I <br /> CLASS OF WORN <br /> O NEW ❑ AODITION O ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE }� SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALl1ATION OF WOFK <br /> S 6ra�0.�� <br /> OESCRIBE 1VORK <br /> Install sign on buildiny-illuminated <br /> PRCPOSED USE OF BUILOING <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIPTIONOFPBOPE�TY�SHOYI9ELOWOflATTACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF VVORK WILL BE COMPLIED WITH <br /> �or_o�ocrc_oF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> J00 AOORESS SIGNATUR F GONTPACTOR OR AUTMORIZE�AGENT DATE <br /> 10115 Evergreen Way X 1 7 1,L-FS� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATERCLOSET�TOILEn .4�R CON�. UNITS— H.P. EA. <br /> BHTHTUB RcFRIGERATION UNITS— H.P. FA. <br /> LAVATO'nY�WASH BASIN) BOILERS— N.P. EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 OISP. FORCED AIR SYS7EMS— a.T.U. M EA. <br /> DISHWASHER WALL HEATERS — �.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS— B.7.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN (7ANGE HOOD <br /> FLOON DRAIN AIR HANDLING UNIT— C.F.M. <br /> VAGUUM BREAKERS STOVE— N100D <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE&CHIMNEY <br /> SINK ISERVICE— BAR, c7C� FIREPLAGE INSERT <br /> HEAT PUMP <br /> SUB TOTAL � SUB TOTAL S <br /> PEHMIT 5 PERMIT 5 <br /> 70TAL FEE 5 TOTAL F[c S <br /> SIDE YAR[ISETeACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECGIPT NO. <br /> USE ZONE LO7 AREA VACANT SI7F FEES VALUATION FEE <br /> �:-:YES : �,NO <br /> T'1PE OF CONS7. OCCUPANCY GROUP NO. OF DWELLING UNITS <br /> BUILDING 5 6,000. 21 00 <br /> SIZE OF BLDG. �O.OF STORIES IAAX.OCC. LOAD <br /> PLUMBING <br /> FIREZONE BASEMENT FIRESPRItJKLEflS MECHANICAL <br /> REOUIRED <br /> :�,YES '�.NO <br /> APPROVALS BY DATE OTFILR <br /> 1. ENVIRONMENTAL CHECH LIST PENALTY U.B.C. <br /> SEC.3U3(a) <br /> 2.BUILDING PLAIJS TOTAL 21 OO <br /> 3.FIRE HYDRANT <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIUATION <br /> — WHEN PROPERLY VALIDA7ED(IN 7HIS SPACFI 7HIS IS YOUR PERMIT N <br /> S.GRADWG . ,. � . . . (j,l <br /> 6.DRAINAGE - � ��-- - y-� <br /> 7.ENVIRONMENTALIM.PACTSTATEMENT L(� <br /> A.HEAL7H DISTRICT �"'� <br /> AFPLICATION ACC. BY PI.ANS CHECKED BY APPR.FOR ISSUANCE BI' - <br /> LC � <br /> ADDRESS FlLE <br />