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the Etvrgreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT, WA 98201 <br />"ONSTRUCTION' <br />PERMIT <br />IJ COMBINATION CX BUILD!NG ❑ MECHANICAL <br />PERMIT NO. 14722 <br />❑ PLUMBING <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Ackerley Communications <br />3601 6th Avenue South Seattle <br />98134 <br />682-3833 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />Z:P <br />PHONE <br />GENLRAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE Y <br />Same <br />ACKERL*245JR <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENS! A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 0 <br />❑ NEW ❑ ADDITION ❑ ACERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE 7LASICN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />$ 1300.00 <br />..Ll - - J' -A V.--- ..,. -1 <br />+y PROPOSED USE OF BUILDING <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 VIOLA fE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONS'i RUCTION. <br />SIGNATURE OF CONTRACTORNIZED AGENT DATE <br />X '�A — <br />LEGALDESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES( <br />LOT -BLOCK __OF <br />JOB ADDRESS <br />31 S.E. Everett Mall Way <br />PLUMBING <br />MECHANICAL( <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATERCLOSETITOILET) <br />AIR COND. UNI'S - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />_ <br />IA ATORY(WASH BASIN) <br />BOILERS - H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />' CISHWASHER <br />WALL HEATERS - B.T.U. M <br />_ <br />LAUNDRYTRAY <br />UNIT HEATERS - BTU. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />- <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING )NIT - C.P.M. <br />VACUUM 6REAY.ERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACES CHIMNEY <br />_ <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />i <br />SUB TOTAL S <br />_ <br />PERMIT <br />$ <br />PERMIT S <br />TOTAL FEE <br />S <br />TOTAL <br />FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />-YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DW'cLLING UNITS <br />BUILDING <br />S 1300. <br />2 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />- <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES ENO <br />MECHANICAL <br />OTHcR <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (R) <br />2. BUILDING PLANS <br />— <br />TOTAL <br />22 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5GRADING <br />. <br />PERMIT VALID.%TION <br />N THIS SPACE) THIS IS YOUR PERMIT. _ <br />WHEN PROPEHLY VALIDATED U(` <br />n <br />Not to exceed 30' in height. I— <br />6 DRAINAGE <br />7.ENVIRON MENTAL I M PACT STATEMENT <br />E. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />I PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />NV/LC <br />-� TI <br />Nm <br />0 <br />C O <br />m o <br />�c <br />O 3 <br />-I z <br />m _ <br />C7 2 <br />C <br />D -H <br />1 N <br />O A <br />M D <br />3 <br />=m <br />M <br />N <br />or <br />C= c Ln Ln <br />3 N <br />m <br />z t� <br />rn <br />- r <br />D3. <br />A <br />-r*; j 9I" <br />21 <br />I <br />