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11 <br />t.. <br />the E1rrAreen _ _ <br />evereCITY OF <br />tt I CONSTRUCTION <br />PERMIT <br />CITY HALL 259 8745 n <br />EVERETT, WA 98201 [2 COMBINATION ® BUILDING 1I MECHANICAL <br />PERMIT NO. 12307 <br />10 PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />H & L Sporting Goods 2802 Hoyt Everett 98201 259-5515 <br />ARCHITECT OR DESIGNER. MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 9 <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE / <br />CLASS OF WORK <br />❑ NEW (R7(DDITION }q XALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />ALUATION OF WORK <br />$ 35,000.00 <br />DESCRIBE WORK <br />Interior tenant improvement <br />PROPOSED USE OF BUILDING <br />retail sales <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 OF LAWS AND CRDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING C014STRUCTION OR THE <br />PERFORMANCE OFCONSTRUCTI N. <br />SIGNATURE F C TFACTOR OP AUT ORI D G T qATE <br />X 9j <br />LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT -BLOCK -OF <br />JOB ADDRESS <br />1512 S.E. Everett Mall Way <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR CCND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />1 <br />LAVATORY(WASH BASIN) <br />2 <br />Q Q <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK& DISP. <br />1 <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />6 <br />00 <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />1 <br />WATER HEATER <br />2 <br />On <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />3 <br />00 <br />DRINKING FOUNTAIN <br />RANGE HOOF. <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />$ <br />SUB TOTAL $ <br />9 <br />00 <br />PERMIT <br />$1 <br />1 <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />9 <br />00 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />83/12307 <br />PLAN <br />FEE <br />140.08 <br />CHECK FEE <br />RECEIPT NO. <br />USFZONE <br />LOT AREA <br />VACANT SITE <br />❑YES :-NO <br />FEES <br />VALUATION <br />1�_ <br />TYPE OF CONST. <br />III-N <br />OCCUPANCY GROUP <br />B-2 <br />NO. OF DWELLING UNITS <br />BUILDING <br />$35 , 000. <br />215 <br />50 <br />SIZE OF BLDG. <br />43 Sq. Ft. <br />NO. OF STORIES <br />MAK OCC. LOAD <br />41 <br />PLUMBING <br />6 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />S ENO <br />MECHANICAL <br />9 <br />QQ <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS �.t1 <br />TOTAL <br />2 3 0 <br />5 0 <br />3. FIRE HYDRANT o <br />4. FIRE PROTEe13ON SYSTM <br />PERMIT yaqq�1IgQpI�'�,10 ;p7�I�, <br />PPdPBRI`Y•YAL ATED (IN THw $P•QC,E) THIS�S�YjU@ P5RU <br />Il 7 U i [ J (JC1' <br />1'R FECEIP1' M <br />iJ� N <br />Lj U YOUR RECEIPT *-+ <br />i, •ANK, YO <br />THANK YOU <br />._ 0 2 <br />.5. GRADING '- <br />•(. DRAINAGE — EA <br />.7. ENVIRONMBNiALIMPA STATEMENT <br />nCT <br />,APPLI58. OATI NBY PLANS CHECKED BY <br />� m xwM <br />C 7 <br />APPR. FOR ISSUANCE BY <br />1 <br />L <br />15 Aug 0 j <br />1 3 AUG 8 3 <br />ADDRESS FILE <br />