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. <br /> Nie Erergreen — C�N ST R l)4�/�I�!� <br /> 1 <br /> CITY OF <br /> ev�rett PE��7"� PERMIT NO. O?29Z <br /> CITY HALL 259�8745 <br /> EVERETf,WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUMBING <br /> OWNER MAILA��RE55 CI7Y ZIP NFONE <br /> KENS CAMERA 85Q7 EVERGREEN �PAY <br /> AFCHITECTOROESIGNEN MAIIAD�FESS CITY ZIP PNONE <br /> GENERAL CONTRACTOP MAIL ADDRE55 CITY 21P PNGVE LICENSE I <br /> MECHANICALCANTfiACTOR MAILADDRESS Cltt '_IP PHOfIE LICENSEI <br /> PLUMBINC.CONTRACTOR MAILADDRESS Cltt 21P PHON2 LICENSE� <br /> RUCKER AVE PLBG 25�—�867 <br /> ClA55Of WOFK <br /> �C]NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMCLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VFLUATION OF WORK <br /> S <br /> OESCRIBE WORK <br /> PROPOSED USE OF BUII�ING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> LEGALDESCRIPTIONOFPPOPEFTY�SHOWBELOWOflATTACHFOUHCaPIES) PLICATlON AND KNOW THE SAM[ TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior e�ocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO- <br /> '�ISIONS OF ANY OTHER STATE OR LOCAL LAW REGUU+TING <br /> ONSTRUCTIO OR T RF RMANCE OF CONSTRUCTION. <br /> SIGNAT' E r ON CTOROP �HOR AGENT DATE <br /> JOB AOpRESS <br /> 8907 EVERGREEN WAY X <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(�OILET) AIR COND.UNITS—H.P.EA. <br /> BATHTUB REFRIGEflATION UNITS—H.P.EA <br /> LAVATORY ryYASH BASIN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS—iONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTENS—6.T.U. M EA. <br /> DISHWASHER WALL HEATERS—B.T.U. M <br /> LAUNDRVTRAY UNITHEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS — <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DFINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.f.M. <br /> VACUUM BREAKERS STOVE <br /> POOF DRAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> MNK�SERVICE—BAR.ETC.) — <br /> SUBTOTAL SUBTOTAL 5 <br /> PERMIT t PERMIT 3 <br /> TOTALFEE E TOTALFEE E <br /> SIDE YAHD SEiOACK STREET SETBACK RFAR YARD SETBACh: PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE fiECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> . ❑YES GNO FEES VALUATION FEE <br /> TYPE Of CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS l, <br /> BUILDING $ <br /> SIZE OF BIDG. N0.OF STORIES MA%.OCC.LOAD <br /> PLUMBINCa <br /> FIRE ZONE BASEMENT REOUIRED KLERS MECHANICAL <br /> ❑YES ❑NO <br /> APPNOVALS � BY DATE OTHER <br /> 1. ENVIRONMENTALCHECKLIST PENALN U.B.C. ' <br /> SEC.303(a) <br /> 2. BUILDING PLANS <br /> TOTAL � p <br /> 3. FIRE HYDRANT <br /> 4. FIRE PFOTECTION SYSTEM PENMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING CV',Z <br /> 6. DRNNAGE �� g O 6 6 �D O�•o O �fJ <br /> Z ENVIRONMENTALIMPACTSTATEMENT � . � N <br /> ti <br /> B. HEALTH DISTRICT <br /> APPLICATION ACC.Bl' PIANSCHECKED BY APPR.FOR ISSUANCE BY YO U R REC EtP <br /> 1� Tt-;ANK YOU <br /> r . <br />