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CITY OF <br />— — <br />eVerPft <br />PERMIT <br />PERMIT NO. <br />08722 <br />CITY HALL 259 8745 <br />❑ COMBINATION ®[BUILDING El MECHANICAL <br />ElPLUMBING <br />EVERETT, WA 98201 <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />H 6 L Sporting Goods 2802 Hoyt P.venue <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP IF <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE <br />Heath N.W. <br />Inc. 11805 N.E. 116th Kirkland <br />98033 828-4596 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE <br />HE <br />AT HN *330RJ <br />I ICENSE <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION El REPAIR ❑DEMOLITION ❑FENCE MXIGN DGARAGE <br />$ 2500.00 <br />ereuc SJL911 <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DESCRIPTION OF PROPERTY JSHOW BELOW OR ATTACH FOUR COPIES) <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT -BLOCK -OF <br />HEREIN OR NO -I. T::= GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHUHITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />JOB ADDRESS <br />1402 South Broadway Space 122 <br />X <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR COND. UNITS — H.P. EA. <br />WATER CLOSET (TOILET) <br />REFRIGERATION UNITS — H.P. EA <br />BATHTUB <br />BOILERS — H.P. EA. <br />LAVATORY (WASH BASINI <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />SHOWER <br />FORCED AIR SYSTEMS —B.T.U. M EA. <br />KITCHEN SINK 8 DISP. <br />WALL HEATERS—B.T.U. M <br />DISHWASHER <br />UNIT HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />WATER HEATER <br />VENTILATION FAN <br />URINAL <br />RANGE H000 <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT — OF M, <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />METAL FIREPLACE & CHIMNEY <br />ROOF DRAINS — RAINLEADERS <br />_ <br />SINK (SERVICE —BAR ETC.) <br />SUBTOTAL <br />$ <br />SUB TOTAL <br />PERMIT <br />$ <br />PERMIT <br />S <br />TOTAL <br />FEE S <br />TOTAL FEE <br />SIDE YARD SETBACK STREET SETBACK <br />S <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />SITE <br />VACANT ENO <br />EIYESTYPE <br />FEES <br />VALUATION <br />FEE <br />OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />s 2500.00 <br />15 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />OYES ❑NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />2. BUILDING PLANS <br />TOTAL <br />15 <br />00 <br />3, FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION ,c <br />WHEN PROPERLY VALIDATED (IN THIS SPAOI)SF�SbS YOU �PAM1�. O -- <br />N <br />N <br />5. GRADING <br />6. DRAINAGE <br />_ LT <br />�• -� <br />7, ENVIRONMENTAL IMPACT STATEMENT <br />(y7� <br />. ; -� I vo?) <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />BAB <br />- <br />15Jtu481 <br />ADDRESS FILE <br />