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rhe /_ rrrt rern <br />�,,�� <br />everett <br />CI7V HALL 259�8745 <br />EVERE7T, WA 98201 <br />� �on�sTRucTior� <br />PERMIT <br />❑ COMBINATION ❑ BUILDING C�XMECHANICAL <br />PERMIT N0. 12HO7 <br />❑ PLUMBING <br />ON'�'ER MAIL AD�RESS �IiY 21P PMONE <br />r LOUISE SID1S 2804 Grand Avenue Everett 14A 339-2288 <br />ARCMITECT OR �ESIGNER lAAIL AD�RESS dTY 21P pHONE <br />1 <br />GENERAL CONTRACTOR MAI! ADORE55 CITY ZIP pHONE UCENSE • <br />Restaurant Eauipment Brokers 19015A - 36th Ave 1V Iynniaood It'A 98036 <br />MECMANICAL GONTRA�TOR MAIL ADDRE55 �ITY ZIP PHONE LICENSE I <br />r:ur.�c:r:r.ccnrr.<cma . r:r.::;,ocncss � � c;rr z�� FNOKE LICCt:LCA <br />❑ NEW ❑ ADDITION �„�] AL7EHATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN � WOOD STOYE/FIREPLACE INSERT <br />n <br />YALUATION pF WORK <br />t <br />Restaurant <br />.EGAL DESGRIPt10N OF PROPERTY �SNOW I <br />LOT_BLOCK_OF <br />IOB AD�RESS <br />_ 2802 Grand Avenue <br />PLUMBING <br />?YPE OF FI%TUHE OF <br />WATER CLOSET (TOILFT) <br />BATHTUB <br />LAVATORV�WASHBFSIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />�AUNDRVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKEFS <br />ROOF ORAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETQ) <br />PERMIT <br />TOTAL FEE <br />USE ZONE <br />SIZE OF BLDG. NO. <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUIL�ING PLANS <br />3. FIRE HYDRAN7 <br />a. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIHONMENTALIMPACTSTAT <br />8. HEALTM DISTRICT <br />APPLIGATION ACC. BY PLAP <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 VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />�SIGN `'� pF "TRFCTORORAUT AGENi DAiE <br />7`TiLGL�r�� mva 12/13/83 <br />FEE NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UN!TS — TONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORAiIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RFNGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSER7 <br />HEAT PUMP <br />S <br />f <br />f <br />VACANT SITE <br />:�'.YES ::NO <br />MA%.00Q LOAD <br />VES '..NO <br />CMECK <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />SU8 TOTAL <br />PERMIT <br />TOTAL FEE <br />i <br />FEE <br />VALUATION <br />E <br />U.B.G. <br />SEC. 3D3 lal <br />FEE <br />f � <br />s 10 <br />S 17 <br />CHECK FEE <br />RECEIPT NO. <br />FEE <br />TOTAL I I 1% Q <br />PEHMIT VALIDATION <br />— WHEN PROPERLV VALIDATED (IN TMIS� =P?Ci) THIS (SOYOi �PERM17—� 1 <br />��� 0 5U <br />� <br />� <br />BY APPR. FOR ISSUANCE BY , ''.� � i� �" C[ I P i r+ <br />' '.^�`: 1";�U <br />I ,l ��� U J <br />ADDRESS FII C- <br />� <br />