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the Evergreen <br />C'T'IOF ClI N ST R U CTI O N <br />everetPERMIT PERMIT NO.08438 <br />CITY HALL 259-8745 <br />EVERETT, WA 99201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL Rlt PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />H & L Sporting Goods <br />ARCHITECT OR DESIGNER ✓"!:'11DRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 9 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY <br />LICENSE 1 <br />PLUMBING CDNTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Glantz Supplty Inc. 3332 Spruce Everett 252-2442 <br />VV ❑NEVI ❑ADDITION ❑ALTERATION ❑REPAIR El DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />x <br />WORK <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 />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 LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION <br />SIGNATURE OF CONTRA, ;OR OR AUTHORIZED AGENT DATE <br />Y. Check #59697 10/16/80 <br />LEGAL DESCRIPTION OF PROPERr( (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOr BLOCK__OF <br />'— <br />JOB ADDRESS <br />1512 South Broadway <br />PLUMBING —tee— <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />1 <br />WATER CLOSET (TOILET) <br />2 <br />n n <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />1 <br />LAVATORY (WASH BASIN) <br />2 <br />00 <br />BOILERS - H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />_ <br />DISHWASHER <br />MALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS_ <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />1 <br />FLOOR DRAIN <br />nn <br />AIR HANDLING UNIT — C.F.M. <br />_ <br />_ <br />VACUUM BREAKERS <br />STOVE <br />_ <br />ROOF DRAINS — RAINLEADERS <br />j <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />6 <br />00 <br />SUB TOTAL S <br />PERMIT <br />S <br />_ <br />3 <br />100_ <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PUO! CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$ <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />9 <br />00 <br />FIRE ZONE <br />BASEMENT <br />HHE SFRIN!<'.ERS <br />REQUIRED <br />OYES ❑NO <br />MECHANICAL <br />_ <br />APPROVALS <br />BY <br />CATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC. 303(a) U.B C. <br />2, BUILDING PLANS <br />TOTAL <br />-- <br />9 <br />— <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />00 <br />92 $009.00 M <br />ol — <br />`('�:''JR RECEIPT <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />6. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />