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�hr L�rer�reen <br />,�,,<< <br />everett <br />CITI' HAL� 25&87d5 <br />�ONSTRUCTI�iV <br />�"ERMIT PERMII' NO. ��6J5 <br />EVERETT. WA 99201 � COIdBINATION � BUILDING ❑ MECHANICA.L ❑ PLUMBINI' <br />OWNER MqILADORESS QTV ZIP PHONE <br />Pay-N-Save 1325 S.E. Everett Mall Way Everett 98201 <br />ARCNREGT OF OESIGNER MA:L FpORE55 CITY ZIP P40NE <br />GENEHAL CONTRACTOP MAII AD�PESS CIiY 21P PHON[ LICENSE Y <br />Heath Northwest Inc. 11805 116th Kirkiand 98034 623-3100 <br />MECMANICAL GON�RACTOR MAIL AODFE55 GTV ZIP PHONE LICENSE N <br />HEATHN*330RJ <br />F"_UMBING CONiPAr10R MAIL ADORE55 CITV ZIP PMONE LICENSE Y <br />❑ NEW O ADDITION ❑ AL7E(iATION ❑ REPAIR ❑ DEMCLI710H O FENCE �SIGN ❑ WOOD STOVEIFIREPLACE WSERT <br />VAI.UAfION OF WORK <br />t i�80�.0� <br />OESCRIBE �YORR <br />Install illuminated sign <br />LOt _ F�LDCK _ OF <br />1325 S.E. Everett Mall Yiay <br />PLUMBING <br />NC. TYPE OF FU(TURE OR ITEM <br />W ATE R CLOSET (TOILET) <br />�ATH'r�B <br />LAVATORY(WASIIBASIN) <br />SHOWFR <br />KITCHEN SRdK 8 DISP. <br />DISHWASHER <br />LAUNDFIV TRAY <br />CLO7HES WASMER <br />WATER IIEATER <br />URINAL <br />DRINKMCi FOUNTAIN � <br />FLOOR DFIAIN <br />b'ACUUM 6REAKERS <br />R07F �RAIN:�— RAINLEADERS <br />SINK (SERb'ICE — BAR, ETC.1 <br />SUB TOTAL <br />PERMIT <br />rrr��� TOTAL FEE <br />SIDE YARD SETBACH �a7REETSETBACK <br />USE ZONE �LOT AREA <br />TYPE OF CONST. OCCUPANCY GROUP <br />SIZE OF BLDG. NO. OF STORIES <br />FIREZOIJE BASEMENT <br />APpROVALS <br />7. ENVIRONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />3. flflE MVDHANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIflONAtENTALIMPACTSTATEMENT <br />e HEALTH DISTRICT <br />APPLICATION ACC. BV PLANS CHECKED BY <br />FOUR COPIES� <br />I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNGW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WOf;K WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO <31VE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIUNS OF ANY OTH�R STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />FERFORMANCE OF CONSTRUCTION. <br />SIGNATU� �OF /GON�TRAGTOR fl IUTM IZEO AG[/NTo /� DATE <br />X �./[.tif_/ �19�A�/.�'/ �� <br />MECHANICAL <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />AOILERS — H.P. 'eA. <br />GAS FIflED A.C. UNITS — TONNAGL EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNI7 HEATERS — B.T.U. M <br />EVAPORA7IVE COOLERS <br />CLO7HES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — INOOD <br />METAL FIflEPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />f <br />S <br />S <br />HEAR YARD SETBAGK PLAN CHE( <br />VACANT SITE <br />',-:YES LINO <br />NO. OF DWELLING UNITS <br />BUILDING <br />MA%. OCG LOAD <br />PLUM�ING <br />FEE <br />SIIB TO7AL 5 <br />PEPMI7 S <br />70TAL FEE S <br />I Nl1M8ER PLAN CHECK FEE <br />FEE I RECEIPT NO. <br />FEES VALUATION FEE <br />MECHANICAL <br />!:N�DA7E OTMER <br />i. FOR ISSUANCE BY <br />idV/LC <br />11/4/85 <br />PENALTV <br />s 1,800. <br />U.B.C. <br />SEC. 303 (a) <br />��� <br />TO7AL I � � Iv� <br />PERMI7 VALIDA710N <br />WHEN PPOPERLY VALIDATED pN THIS SPACE) 7HIS I� y0{�R PE�A�}�T __�� <br />511h UUY u <br />iS� <br />1!l <br />. . . .-. 1,_�.� �_ � �' �. . <br />. �i �) �� <br />ADDRESS FILE <br />- ; i;�J o'� <br />