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Me Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />PONSTRUCTION - <br />PERMIT <br />❑ COMBINATION XE IJUILDING ❑ MECHANICAL <br />PERMIT N0. 09913 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />THE BROKERAGE RESTAURANT 3120 HEWITT EVERETT WA 252-1139 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE E <br />QUIL CEDA CONSTRUCTION 9805 Hwy 99 S Marysvi-le 659-8050 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />CLASS OF <br />❑NEW ❑ADDITION XXALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN CIGARAGE <br />VALUATION OF WORK <br />: 300.00 <br />DESCRIBE WORK <br />20' wall 10' high <br />PROPOSED USE OF BUILDING <br />Wine cellar <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 CONTRACTOR OR AUTHORIZED AGENT DATE <br />X ) 1 10/16/81 <br />LEGAL DESCRIPTION OFPROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />1- 11 ell s 1 t Add <br />LOT 3 BLocK 697 of <br />JOB ADDRESS <br />3120 Hewitt <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 COND UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS — TONNAGE EA <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. III <br />LAUNDRY TRAY <br />UNIT HEATERS — BT.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C EM. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC) <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />TOTAL <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />I IYES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$300.00 <br />10 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />❑YES FNO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U BC <br />SEC. 303 (a) <br />?. BUILDING PLANS <br />TOTAL <br />10100 <br />3. FIRE HYDRANT <br /><. FIRE PROTECTION SYSTEM <br />— <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />! <br />r <br />Cr <br />I <br />I C <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />