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Uie EverAreen r����ST R U CT I O N � <br /> CITY OP <br /> evepett f'ERMIT PERMIT NO. 11264 <br /> CITY HALI 259�07n5 <br /> EveFerr,wa 9ozo� ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBINu <br /> OWN[P MAILADDPESS GiTY ZIP �MONE <br /> P1e1 Berg 510 92nd Street S .E. Everett 98204 353-5878 <br /> ARCMITECT OR DESIGNER MAIL nDDRESS CITY ZIP �HONE <br /> G[NERFLCONTRACiOfi M4ILFODRESS QTY ZIP P�{ONE LICCNSEI <br /> Duane Berg 2704 128th Street S.W. Everett 98204 353-6229 <br /> MECHANICALCONTRACiOR MAIL�OD�ESS CITY ZIP PHONE UCENSEY <br /> DO AN EM B224DA <br /> PlUl.IBINGCONTfiACiOR MAILAG�PE55 QTY 21P PMONE UCENSE/ <br /> CLA55 OF YlORK <br /> ❑NEW ❑ADDITION �NLTERATION ❑RPPA!R ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUAT�ON OF\VOFK <br /> S 700 . 00 <br /> DESCA��E WORK <br /> Install fire door and drive—in window <br /> �noPoseo use or euaowc <br /> retail sales I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEL THIS AP� <br /> �eca�oescnirnor+oFaaoaea*ris�owee�ovio�nTrncNFouacoaiesi PLICATION AND KNOW THE SAW1E TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or o�oc�_oF TYPE OF WORK WILL BE COMPUED WITH WHETHER SPECIFIED <br /> HCREIN OR NOT. THE GRANTING OF A PERMIT GOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISION OF ANY OTHEFi STATE OR LOCAL LAW REGULATING <br /> GON37RU TION OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATUfth OF ONTMCiOR OR FUTIiOR ED AGEM OFTE <br /> JO�AO�RE55 1 11/18/8 2 <br /> II907 Evergreen Way X� __ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> 4VATER CLOSET(TOILET) AIR COND.UNITS—H.R EA <br /> BATHTUB FEFRIGERATION UNITS—H.P.EA <br /> IAVATOP.Y(WASH BASIN) BOILERS—HP.EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHEfl WALL HEATERS—B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS—BT.U. M <br /> C�OTHES NJASHER EVAPOflA7NE COOLERS <br /> VJATER HEAIER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DFAIN AIR HANDLING UNIi— GF.M. <br /> VACUUM BREAKERS STOVF <br /> ROOF DR�INS—RAINLEADERS MEiAL FIREPLACE&CHIMNEY <br /> SINK RERVICE—BAR.ETC) <br /> SUB 707AL SUB 70TAL S _ <br /> PERMIT S PERMIT _ S <br /> TO7AL FEE S TOTALFEE 5 <br /> SIDE YA��f1 SET�FCK STREET SETBACK REAR YARD SET�ACK PLAN CHECK NU�d�ER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> U'.E ZOqE LOT AFEA VACANT SITE FEES VALUA710N FEE <br /> ilYES ❑NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> ' BUILOING 5700 . 00 13 00 <br /> SIZE OF BLDG. NO.OF S10R�ES MAX.OCC.LOAD <br /> PLUM6ING <br /> FIRE ZONE BASEMENT REOUIREU KLERS MECHANICAL <br /> LiYES I_1N0 � <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY � U.B C. <br /> SEC.303(a) <br /> 2. BUILDING PLANS 13 OO <br /> TOTAL <br /> 3. FIRE HYDRANT <br /> d. FIRE PRO7ECTION SYSTEM PERMIT VALI�ATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS VOUR PERMIT <br /> S. GRADING 0145 $0 � 2, 00 ,`_ ,Ai. <br /> , 6. DRAINAGE _ , : � �y{ <br /> e � N <br /> " 7. ENVIRONMENTALIMPACTSTATEMENT � � . <br /> . � c� <br /> 8. HEALTH DISTRICT YO•U`R 'R E,�E 1 PT � <br /> APPUCATION ACG BY PIANSCHECKED BY APPR.FOR ISSUANCE BY 7NiaNK YO U��� ' <br /> HWM <br /> � <br /> ' - 1 8 �Y 8 2 <br /> ���ooa�ss ri�e . . _ �_�__._ _ .. _ <br />