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Y <br /> �' theEvergrcen CC"�ISTRUCTION - -m� i <br /> i � cin oF <br /> ,� everett � PERMIT pERMIT NO. �$1�0 <br /> � CITY HALL 259�8745 � COMBINATION ❑ BUILDIN(i � MECHANICAL ❑ PLUMBINO <br /> EVEFETT.WA 98201 . <br /> OWNER MAILApDPE:S CITY ZIP P110NE <br /> 1011 Reataurant 1011 Hewitt Everett 98201 <br /> 4qCH1iEGT OP DFSIGNEP MAIL ADDPESS CI�I' ZIP PMONE <br /> GENEHNLCONTRPCTOP MAII.ADDRE55 CITY 21P PMW1E IIGEN5E1 <br /> MECHANICALCONTRALTOR MAIIADDRE55 CITY ZIP PNONE LICENSEI <br /> Brodie/Dohrmann. Inc. 1900 15th Aven West Seattle 98119 281-4958 <br /> PLUNBINGCANTPACTOR IAAILADDRE55 CITV ZIP PHONE LICENSE� <br /> CUSSOF WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑�EMOLITION ❑FENCE ❑SIGN ❑GAMGE <br /> VALU�TIGN OF WOIiK <br /> f <br /> OESCRIBE WORN <br /> PPOP0.5E0 USE OF BUILDINO <br /> I HEREBY CERTIFY iF�',T I HAVE READ AND EXAMINED THIS AP• <br /> LEGA��ESCflIPT10NOFPflOPEFTY�SMOWBF.IOWOBATTlLHFOURCOPIES) PLICATION AND KNG1� THE SAME TO BE TFUE AND CORRECT. <br /> ALL PROVISIONS CF L4WS AND ORDINANCES GOVERNING THIS <br /> �or aioc�_oF TYPE OF WORK Wf.L BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GI'JF:AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> r,ONSTRUCTION OR THE PERFORMANCE OF CANSTRUCTION. <br /> JOBAO�RESS SIG.�RiUPEOFCANTMCTOBORAVTHORIZEDAGENT DATE <br /> 1011 Hewitt: X Check #52927 8/12/80 <br /> PLUMBINO MECNANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE ' <br /> WATER CLOSET(fOI�En AIR COND.UNITS—H.P.EA. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA <br /> LAVATORV(WASH BASIN) BOILEFS—H.P.EA. <br /> SHOWER GAS FIPED A.C.UNITS—TONN�GE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SVSTEMS—B T.U. M EA. <br /> OISMWASHER WALLHEATERS—B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATEN HEA7ER CLOTliES DRVERS <br /> URINAL VEMILNTION FAN <br /> DRINKING FOUNTAIN 1 FANGE HOOD <br /> Fl,OOR DRAIN AIR HANDLING UNIT— GF.M. <br /> VACUUM BPEFKERS STOVE <br /> ROOF DRAINS—RNINLFADERS METAL FIREPLACE B CHIMNE� <br /> SINK�SERVICE—BNR.ETC_I <br /> SUB TCTAL SUB TOT!� f 3 U U <br /> PEHMIT S PENMIT f O <br /> TOTALFEE f TOTRLFEE f <br /> SIDE YARD SETBACK SiREET SETBACK flEAR YARD SETBACK PLAN C'�ECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE FEES VRLUATION FEE <br /> ❑VES LNO <br /> TYPE OF CONST. OCCUPANCY aROUP NO.OF DWELURG UNITS <br /> BUIIDING E <br /> SiJ.E OF BLDG. NO.OF S70RIE5 MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL 6 OO <br /> REOUIRED <br /> ❑YES ❑NO <br /> MPROVAlB OY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENAL7y U.B.C. <br /> SEC.303(a) <br /> 2. 9UILDINGPLANS 6 00 <br /> TOTAL <br /> 3. FIRE HYORP'�T <br /> 4. FIRE PROTECTION SYSTEM PENMIT VALIDATION <br /> WHEN PROPEHLY VAU�ATED pN THIS SPACE)THIS IS VOUR PERMI7 <br /> 5. GMDING r Q <br /> 6. DRAINAGE 6 I 5 3 y � � �. O O � <br /> 7. ENV�RONMENTAL IMPACT STA7EMENT � <br /> � <br /> B. MEALTH DISTRICT <br /> APPLIGTION ACC.BY PU1N5 CHECKED BY APPR.FOR ISSUANCE BV 1(�../ �J IC REC[I Pl� <br /> x.c. i': ir�,`�;K. YOU <br /> ADDRESS FILE I � ��J� 80 <br />