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Ihc EverAreen <br />c�rv oF <br />�- everett <br />GITY HAt'. 259-8745 <br />EVERE'. �. WA �8201 <br />� -� - CONSTRUCTIO�'' <br />PERMIT PERMIT NO. 145C 5 <br />❑ COMBINATION I� BUILDING ❑ MECHANICAL ❑ PLUMBING <br />e o PHONE <br />OWNEfl Mni� noor+e�a -- - 682-3833 <br />Ackerly Cormaunications 3601 6th Avenue Seattle 98134 <br />ARCHITECi OR OESIGNEF MAIL AODFESS <br />CITY ZIP PMONE <br />CITY ZIP PHONE LICENSE N <br />GENERAL COtlTRAGTOF MAIL ADDRESS � <br />same <br />MECHANICALCONTFALTOR <br />MAIL A�OFE55 CIiY ZIP PHONE LICENSE M <br />PLUMBING CONTflACTOR MAIL AD�RESS <br />dTY ZIP PNONE LICENSE N <br />O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION � FENCE }� SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />f 2000.00 <br />Install outdoor advertising sign <br />RT-38-C) W 200' MEAS AT R ANG <br />�p7__BLOCK__�F <br />70 ST RD OF S 341' OE SE�t SEi SWi LYE ST RD1 <br />.....� .. ,�n� <br />9901 Evergreen Way <br />�� <br />PLUMBINO <br />N0. TYPE OF FIXTU!1E <br />WATERCLOSE7�TOILEn <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KI7CHEN SINK & DISP. <br />LAUNORYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS - RAINLE40ERS <br />SINK (SERVICE - BAF, ETC•) <br />OF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS UF LAWS AND ORDINANCES <br />����� �{�g�'f+�FgAi9�IILL BE COMPLIED WITH <br />PERMIT DOES NOIT PRESUMETO GIVEAUTHORITYTOIV OLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION Of. THE <br />PERFORMANCE OF CONSTRUCTION. oATE <br />c�nueniacncCONTRACiQ�FJ'%�AUTMOII2EDAGENT , . �_ <br />MECHANICAL <br />ITEM FEE NO. TYPE OF EOUIPMen7 <br />AIR COND. UNI75 -- H.P. EA. <br />REFRIGEfiATION UNITS - M.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRED A.C. I�NITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.7.U. M EA. <br />WALL HEATERS - B.7.U. M _ <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HAN�LING UNIT - C.F.M. <br />STOVE - W�OD <br />MeTAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSEFT <br />HEAT PUMP _ <br />TOTAL <br />TOTAL <br />7. ENVIRONMENTAL CHECK LIST <br />2. eUILOING PLAI:S <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTAI <br />� <br />� <br />S <br />S <br />3EAR YARD SI <br />VACANT SITE <br />❑VES :NO <br />NO. OF DWEL <br />MA%. OCQ LC <br />BY IAPPR.FOR <br />NV/LNC <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />NUMBER F <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />5 2,000. <br />(a1 <br />� <br />S <br />S <br />CHECK FEE <br />RECEIPT N0. <br />FEE <br />32 50 <br />TOTAL I 32 I $0 <br />PERMIT VALIOATION � ^ � � <br />WHEN PROPERLY VAIIDATED QN THIS SPACE) 7HiS,IS VOUF� PERMI7---- N <br />� <br />i �,:' _� '�' <br />� c-� <br />ii <br />BY -� <br />ADDRFSS fILE <br />i , . <br />z <br />0 <br />� <br />� <br />m <br />.. ., <br />--i � <br />.� � <br />�' m <br />mo <br />f'f <br />O 3 <br />i+� <br />-� z <br />m� <br />p z <br />a� <br />rx <br />�. �. <br />-1 N <br />� <br />O A <br />�'I a <br />3 <br />=m <br />I+1 y <br />o r <br />C N <br />3 v� <br />m <br />2 C7 <br />�r <br />. m <br />a <br />A <br />-i <br />S <br />a <br />Z <br />--1 <br />S <br />o--i <br />N <br />Z <br />O <br />� <br />n <br />m <br />