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r <br /> 1 <br /> d�eEeerFrren � C�NSTRUCTION \ <br /> CITY OF <br /> everett PERMIT pERMIT NO. 10954 <br /> CITY NALL 259�87d5 <br /> EVERETf,WA 98201 ❑ COMBINATION �A BUILDiNG ❑ MECHANICAL PLUMBING <br /> OYfN[fl MAIL ADDRESS <br /> GIiV ZIP PNONE � <br /> PACIFIC NORTHWEST COMMUNICATIONS 2000 - ll6th NE Bellevue 98004 453-5573 <br /> ARCMRECT OR DES�GNEF <br /> MA�I ADDRE55 CITY ZIV PIIONE <br /> ROHN COMMUNICATION Peoria lL <br /> GENERAL CONTRACTOR MAIL AODRESS CITY 2iP PHONE LICENSE♦ <br /> Sound Electronics 4086 - 400 Ave W. Oak Harbor 98227 743-1252 <br /> MCCII�NICFI CONTRAGiOR AIAIL AO�RE55 CITY 21P PMONE l ICENSE� <br /> � 1 <br /> 1 <br /> PLUMBINGCANiNALTOR MAILADOf�E55 Cliv ZIP PMONE IIGENS[� <br /> CLA55 OF WOFK <br /> ❑NEW ❑ADDITION ❑ALTERATIO� ❑REPAIfl CJDEMOL1710N ❑FENC'c ❑SIGN GARAGE <br /> VALUATION OF WORK <br /> 5 � 00�.�� <br /> OESGRtBE\VORN <br /> Install 35' communication tower above existin buildin <br /> aaoaosEo use er aunomc <br /> Paqing transmitter I HEREBY CERTIFY THAT I HAVE READ AVD EXAMINED THIS AP- <br /> �eea�oesca�ano��oFaaoreaTrisNowoeiowor+nnncMFouacoPiesi PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCFS GOVERNING THIS <br /> ior18-22 eioc 2 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 CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL IAW REGULATING <br /> CONSTRUC ION OR T PERFORMANCE OF CONSTRUCTION. <br /> SIGIIAtURE 0 CONTRACTO ��AU�IIO ED�GENi �AtE <br /> JOFIADDFE55 X ,. - p 9/1/82 <br /> PLUMBING ANICA <br /> NO. TY�'E OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> FEE <br /> WATER CLOSET(TOILET) AIR CON�.UNi15— H P.EA. _ <br /> REF(iIGE7AT10N UNITS—H P.EA <br /> BATHTUB <br /> UIVATORV(WASH BASIN) BOILERS—H.P.EA. <br /> GAS FlRED AG UNI75—TONNAGE EA. <br /> SNOl4ER <br /> — PORC[D NR SYSTEMS—B.T.U. M EA. <br /> KITCHEN SINK&DISP. �� <br /> WALL HEATERS—B T U. <br /> DISHWASHER �,q <br /> UNIT HEATERS—B.T.U. _ <br /> LAUNDRYTRAY <br /> EVAPORAi1VE COOLERS <br /> CLOTHES\YASMEP CLOTHES DRVEFS <br /> WATER HEATER <br /> VENTILATION FAN <br /> URINAL <br /> ORINKING FOUNTAIN RANGE HOOD <br /> AIR HANDLWG UNIT— GF.M. <br /> FLOOR ORAIN STOVE <br /> VACUUM BREAKERS <br /> ROOF DRAINS—RAINLEhDERS <br /> MEiAI FIREPLACE G CHIMNE� <br /> $INK�SERVIGE—BAR.E1C.) <br /> SUBTOTAL S <br /> SUB TOTAL PERMIT S <br /> + PERMIT s TOTAL FEE S <br /> TOTAL FEE : pll.N CHECK FEE <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER FEE RLCEIPT N0. <br /> USE ZONE LOT AREA VACANT SIiE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> TYPE OF CANST. OCCUPANCY GROUP NO.OF DWELIING UNITS <br /> BUILOING <br /> 52E�:f IiLDG. NO.OF STORIES MAX.OOC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECRANICAL <br /> � REOUIPED <br /> ❑YES ❑NO � <br /> APPROVALS <br /> BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B C <br /> SEC.3031a) <br /> 2. BUILDING PLANS TOTAL �J 5O <br /> 3. FIRE HYDRANT <br /> PERMIT VALIDIITION <br /> I 4. FIRE PF0IECTION SYSTEM . WHEN PROPERLY VAIIDATED�W THIS SPAQE1TN��IS�O��EW�•5 a � }c' <br /> 5. GRADING 6 1 6 U 1 � 1 <br /> � � <br /> 6. DRRiNAGE • <br /> 7. ENVIRONAIENTAL IMPACi STATEMENT YO U R REC E I� <br /> B. HEALTHDISTRICT THANK YOI� <br /> qppLICATION ACC.BY PLANS CHECKEO BY APPH.FOR ISSUANCE�Y <br /> LNC <br /> _ 3 � aus82 <br /> ADDRESS FILE - - - <br /> . � <br />