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��� <br />CITY OF <br />everett <br />259-8745 <br />�'� C�NSTRUCTION � � = � 21253 <br />PERMIT PERMIT NQ; ; <br />❑ DEMOLITION ❑ COMBINATION C� BUILDING ❑ MECHANICAL ❑ PLUMBING Cl SIGN <br />OWNER MAILAD�R[55 QiY ZIP � 0 <br />Atlantic Richfield Co. P.O. Box ifc 1544 Woodinville, WA 98072-1544 48�- 463 <br />RRCHIT[CTCRDESIGNER MAILADDRE55 CITY 21P PMONE <br />GENENAL CONTRNCTOR MAIL ADURESS CITV ��r `•"""` - <br />Davis Industries Inc. 6425 212th SW Lynnwood, WA 98036 775-9991 DAVISII <br />MECMRNIC/LCONTRACT01i MAILAUORE55 CITY 21P PHONE IICENSE• <br />PLUMBINGCONTR/CTOR MAILAUOPESS CITY ZIP PMONE UCENSEM <br />;LA$$OF WORK <br />❑ NEW ❑ ADDITION <br />/RWATIONOF WONN <br />S %I��� <br />Repair exterior wall <br />IEATSOUHLE <br />❑ ELECTRICITY ❑ GAS <br />Convenience store <br />❑ ALTERATION � REPAIR <br />❑ WOODSTOVE <br />.EGRL �ESGNIPTION OF PROPEPTY �SMOW BELOW OR P� �acn �wn wnca� <br />2 14 Intercity Add Div l, except <br />�or _ oiocK _ oF <br />that portion conveyed to City of Everett._ <br />JOOAOURE55 <br />220 SE Everett Mall Way <br />PLUMBING <br />NO. TYPE OF FI) <br />WATER CLOSET (TOILI <br />BATHTUB <br />LAVATORV�WASM BA'. <br />SHOWER <br />NITCHEtJ SINK 8 DISP. <br />DISHWASHER <br />LAUNORYTRAV <br />CLOTHES WASHEF <br />TVPE OL <br />UA�NAL <br />DPINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF �RAINS — HnINLtnUt <br />SINK ISERVI�JE — OAR. ETC ) <br />BLDG <br />M M <br />OY <br />❑ DEMOLITION <br />❑ OTHEH <br />❑ BUILDING HELOCATION <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVEANING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIV AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIO F ANY OTHER <br />STATE OR LOCAL LAW REGULATING CO STRUCTION OR <br />THE PERF//`'5p'�MANCE OF C9IV6TRUCTI N� <br />clf.��RE mi GONTRACTOR. Al1TyO�ED AGENT. 0� H'�� onte <br />�7EM FEE NO. TVPE OF EOUIPMENT �/ <br />A/C — N/MNDLG UNITS — HP. <br />REFRIGERATION UNITS — M P. EA. <br />BOILERS — B.T.U.�HP. <br />GAS FIRED A�C. UNITS — BSL. <br />FORCED AIR SYSTEMS — �.T.U. M EA. <br />WALLHEATEPS—B.T.U. M <br />UNITHEATEqS—B.T.U. M <br />EVAPORATIVECOOLERS <br />CLOTHES DRVERS <br />VENTILATION F�N <br />RANGEHOOD <br />WATER HEATER � <br />WOOD S70VE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLAC[ INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />PEAMIT <br />TOTAL FEE <br />SiOE SETOaCK PLAN CHECK NUME <br />VpCRNT SITE FEES <br />❑VES ❑NO <br />NOOFOWELL�NGUNIIS BUILDING <br />PLUMBING <br />OF STOPIES ��.�A% OCC LOAD <br />ISSURNGEOY <br />MECHANICAL <br />SUBTOTAI <br />PERMIT <br />TOTALFEE <br />FEE RECEIPT <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGVSURCNARGE <br />DRIVEWAV PERMIT <br />5 <br />r <br />B SRCH �3.� <br />FEE <br />FEE <br />TOTAL � I <br />PERMIT VALIUqTION <br />WHEN PROPERLY VALIOATED �1N iH15 SPACE) TFIIS IS VOU9 PERMIT <br />AUD!IESS FILE <br />m <br />3 <br />F'i7 <br />