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owawrvm <br />CITY OF PONSTRUCTION <br />everett PERMIT PERMIT NO. 18718 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING [ jj MECHANICAL C� PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Union Oil 304 SE Everett Mall Way Everett <br />MAIL ADDRESS <br />CITY <br />PHONE <br />GENERAL CON TRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL. CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL AODRESS CITY ZIP PHONE LICENSE <br />Northwest Energy Systems 20815 52nd Ave. W. Lynnwood, WA 98037 774-2980 NORTHES208PZ <br />CLASS OF WORK <br />® NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR E7 DEMOLITION ❑ BUILDING RELOCATION <br />Rough -in general plumbing <br />HEA.SOURCE <br />O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Gas/Service Station <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 ORDINANCES <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 <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULAT114G CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT E OF CONTRAC R, ORIFFD AGENT, OR OWNER DATE <br />X /j�P- <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW On ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />304 SE Everett Mall Way <br />PLUMBING <br />M CHAN AL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE _ <br />1 <br />WATER CLOSET ITOILETI <br />5 <br />00 <br />MC — A/HNDLG UNITS —H.P <br />BATHTUB <br />REFRIGERATION UNITS —H.P. EA. <br />1 <br />LAVATORY (WASH BASIN) <br />5 <br />00 <br />BOILERS — OT.U/HP <br />SHOWER <br />GAS FIRED ABC. UNITS — B T.U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.0 M EA. <br />DISHWASHER <br />WALL HEATERS—R.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS --B.T.U. M <br />1 <br />CLOTHES WASHER <br />5 <br />00 <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />_ <br />1 <br />FLOOR DRAIN <br />5 <br />00 <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />1 <br />W'ATER HEATER <br />rO <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />1 <br />SINK (SERVICE — BAR. ETC) <br />5 <br />00 <br />METAL FIREPLACE 8 CHiMNEY <br />2 <br />Floor Sink <br />10 <br />00 <br />FIREPLACE INSERT <br />1 <br />Funnel Drain <br />Tj <br />00 <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />S <br />40 <br />1 00 <br />SUBTOTAL <br />PERMIT <br />S <br />PERMIT <br />TOTALFEE <br />$ <br />4 <br />TOTALFEE <br />FRONT SETRACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YLS ❑NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF 61_7G. <br />NO OF STORIES <br />MAX OCC. LOAD <br />MECHANICAL <br />b/t!/Uf 1.1 <br />tPl UGH D: 2i <br />50 <br />FIRE SPRINKLERS REQUIRED CIYES ONO <br />INVESTIGATION FEE <br />c�IQQQQ <br />STATE BUILDING SURCHARGE <br />BUJ >4 <br />v <br />LU <br />STATE ENERGY SURCHARGE <br />C!IECK 1,6 <br />..50 <br />AP%.ICATION ACC BY <br />S.H. <br />PLANSCHECKEDBY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />61 <br />50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />1100 <br />l� <br />r <br />ADURLSS IliC <br />