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' fhe�e.�p"��° �i� �ONSTRUCTIOh+� �1 <br /> '• ���i �'� PGRMIT PERMIT N0. 15341 <br /> CITY HALL 259-8'/a5 <br /> NERETT,WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING <br /> OWNER MAIL ADDRESS CITV ZIP PHONE <br /> Piqnataro 10520 Evergreen Way Everett 98204 <br /> ARGHITECT OR DF.SIGNER MAIL AODflE55 CITY 21P PHONE <br /> GENEf1ALCONTRACT�R MAI�AODRE55 CITV 21P PHONE UCENSEI <br /> MECHANICRL CONTRACTOR MAIL ADDRESS GTY ZIP PHONE LICENSE 1 <br /> PIUMBING CONTFACTOR MAIL AODRE55 CITY 21P PHONE UCENSE/ <br /> KR's Enterprise P.O. Box 1182 Lynnwood 98046 774-8458 <br /> cuss oF wonK * �.7� <br /> ❑ NEW ❑ ADDITIUN O ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ W 7HEPGICE INSERT <br /> VALUATION OF WORK � <br /> f <br /> OESCFIBE WOflK <br /> PPOPOSED USE OF 9UILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL CESGRIVTION OF PflOPERTY�SHOW dE'.OW OR ATTACH FOUR COFIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK_JF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEFiEIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTI N. <br /> JOB ADOflE55 SIGHATURE Of Cq11TRA OR UTHOHIZ GENT DATE <br /> 10520 Evergreen Way X � sl�Xx a/zi/as <br /> PLUMBING MEC ANICAL ' <br /> N0. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> 4 WATERCLOSET�TOILET) AIR COND.UNITS — H.P. EA. <br /> BATHTJB REFRIGERATION UNITS— H.P. EA. <br /> tj LAVATONY(WASH BASIN) BOILERS— H.P. EA. <br /> 1 SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.7.U. M EA. <br /> DISHWASHER WALL HEATERS— B.7.U. M <br /> LAUNDRYTRAY UNIT HEA7ER5— B.T.U. M <br /> CLOTHES WASHER EVAPORA7IVE COOLERS <br /> Z WATER HEATEfi CLOTHES DRVERS <br /> 2 URINAL 4 00 VENTILATION FAN _ <br /> �RINKING FOUNTAIN RANGE HOOD <br /> FLOOR ORAIN AIR HANDLIN i UNIT— C.F.M. <br /> VACUUM BREAKERS S70VE—WOOD <br /> ROOF ORAINS— RAINLEADERS METAL FIREPL4CE 8 CHIMNEV <br /> SINK�SERVICE — BAR, ETC.) FIREPLACEINSERT <br /> HEAT PUMP <br /> sue Tora� s 34 00 sue Tora� s <br /> PERMIT S PEHMIT S <br /> TOTAL FEE = 37 00 TOTAL FEE S <br /> SIOE YARD SETBACK STREET SETBACK REAR YARD SETfiACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZO�E LO7 AREA VACANT SITE FEES VALUATION FEE <br /> i.:YES �:-NO <br /> TYPE OF CONST. OCCl1PANCV GROUP NU.OF DNlELLING UNITS <br /> OUILDING 5 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOA� <br /> I PLUMBING 3'] Be <br /> FIR[ZONE daSEMENT REOUSRED KLERS MECHANICAL <br /> ;"YES :.;NO � <br /> APPROVALS BY DATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENAL7Y U.B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLANS T�TA� 37 00 <br /> 3.FIRE HYDRANT <br /> d.FIRE PROTECTION SYSTEM PEHMI7 VALIDATION <br /> WHEN PROPERLY VALIDATED QN THIS SPACE)THI3 IS YOUR PERMI7 r—( <br /> S.GRADING ___ � <br /> 8.DNAINAGE (Y') <br /> 7.ENVIRONMENTALIMPACTSTATEMENT (!"1 <br /> B.HEALTHDISTRICT - � �.�': <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR.FOfi ISSUANCE BY . . . <br /> ADDR[SS FILE <br />