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1He��'CTveOF �ONSTR�C,�IO� <br /> everett PERMIT PERMIT N0. 1O4�. � <br /> CITY HALL 259�87a5 <br /> eveaen.�vn �azoi ❑ COPABINATION F,�tBUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OYlNER � ldAILAD�RE55 CITY ZIP Ptl011t ._ <br /> Signus Ekkei.kamp 12201 Highway 99 South Everett Wa. 98204 <br /> ARCHiTEGT OR DESIGNER MqILFDORE55 GiTV 21v P110NE <br /> GENERALCAN1RAf.tOR n1AILA0DRE55 CIiY ZIP PMON[ LiCENSE� <br /> Ackerley Communications Inc . 3601 6th Avc:zue South Seattle 98134 682-3833 <br /> MEGHNNICALCONiR4CiUR MAII��DRESS GIiY ZIP PHONE UCEt15E+ <br /> PIUM�I1lG COtliRACiOR IdFIL ADDRE55 GiV 21P PMC:E LiC6NSE• ' <br /> CLASS OF YIORK <br /> ❑NEW ❑A�OITION ❑ALTERATION ❑flEPAIP ❑DEMOLI710N ❑FENCE ❑SIGN ❑GARP;:E <br /> VAIUATION OF WORK <br /> 5 750. �� <br /> DESCRiBE WORK <br /> Move Existing Billboard <br /> caoaoseo use oF evaoiuc <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> �Ec��oeseaiarior+oFr:�oaeerrisNowoe�owonnrrncf�vouFwv���si PLIChTION AND KNOW THE SAME TO BE TRUE AIJD CORRECT. <br /> 1 14 Intercity Div. 1 ALL PRrVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �o. e�oc�_oF TYPE GF �NORK WILL BE COMF.IED WITH WHETHER SPECfFIED <br /> HEREIN OR NOT. THE GRANTI�G OF A PERMIT DOES NOT <br /> PRESUME-i 0 GIVE AUTHORITY TO b'IOLATE OR CANCEL THE PP.O� <br /> — - 'JISIO OF ANY OiHER STATE OP LOCA! LA1N REGULATING <br /> CON R TION OR THE OFMAi10E OF CGiJSiHUCTION. <br /> doenooaess S . E. Everett Mall. Way '16"^T"RE ` ; 4C^croaoan rHo .. o�eru oare <br /> ��� g����X�������� X r �z___ <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF'rIXTURE OR ITEM FEE N0. TYPE OF'cOUIPMENT FEE _ <br /> \'JATER CLOSET(TOILET) - AIR COND. UNITS—HP.EA. _ <br /> BFTHTUFi REF(iIGLRATION UNI?5—H.P.EA _ <br /> LAVATORY(WASH�ASIK) BOILERS—HP.EA. _ <br /> SHOWER GAS FIRED AC.UNITS—TONNAGE FA. _ <br /> KITCHEN SWK E DISP. FORCED AIR SVSTEMS—B.T.U. M EA. ___ <br /> DISHWASHER YJALLi1EATERS—l�.T.U. M _ <br /> l.AU4DRY TRAY UNIT HEATERS—B.T.U. h1 __ <br /> CLOTHES WASHER EVAPORATNE COOLERS _ <br /> WATER HEATER CLOTHES ORYERS <br /> URINAL VENTILJ.TION i AN __ <br /> DRINKING POWTAIN RANGE HOOG <br /> FI OOR DRAIN Alq HANDLING UNIT— GF.M__ __ <br /> VACUU'18P.EAKERS STOVE __ � _ <br /> ROOFDRAWS—�7AINLEADFRS METALFIREPLACE&CHIM1INEV _ _ <br /> SINK(SEFVICE—E3AR,ETQ) <br /> :UBTOTAL GU6TOTAL S _ <br /> PERMI7 S PERMIT = _ _ <br /> TOTAL FEE S TOTAL FEE 3 N„ <br /> SIDE�AflD SETBACK STREET SETBACK REAR VAHD SETBACK PLAN CHECK NUMBER PLAN CNF.CK FEE <br /> FEE RGCEIPT N0. <br /> USE ZONE L0T.4REA � VACANT SITL — <br /> ❑VES GNO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPApI;y''(:,'.%.`.U? N0.OF DWELLING UNITS <br /> OUILDING ° 6 00 <br /> SIZE OF�LDG NO.OF STVi11G5� MA%.OCG :.OAD <br /> PLUMBIN,^i <br /> FIRG ZONE BASEldENT FIRE SPRINKLLRS ti�ECHAMICAL <br /> REOl11RED <br /> I]YES i1N0 <br /> APPHOVALS BY DATE OTHLR <br /> t ENVIAONMENTAL CHECK IIST PENALTY U B C ' <br /> — SEC.3031a1 <br /> 2. OUILDING PLANS <br /> TOTAL 6 �� <br /> 3. FIRE 4YURANT , <br /> 4. KIFE PROTECTION SYSTEM PEHMiT VAIIVRTION <br /> _ WHE4 P�70PFf1L�'JALIDATED(I�d'lHIS SPACE)THIS IS YOUR PERNIT <br /> � 5. GRADING L <br /> I 6. DRAINAGE � 0 9 J � Q 0 b. 0 0 �-� <br /> 7. ENVIRONMENTAL IldPACT STATEAIF.NT � <br /> — � <br /> 8. HEAL7H�157I71CT �'-i U R REC E i PT r� <br /> APPLICATION ACC.OY PLANS CHECKED�Y APPR.FOR ISSUANCE BY � `- <br /> RF NV !I-i����`��. YOU <br /> ADDRES51�•I E I �� F�Pff 8Z <br />