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r% ` E�o C"INSTRUCTION _ qq 934nnvPERMITNQ: <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Csj MECHANICAL 'Cl PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CRY ZIP PHONE <br />Roebling Management 1402 SE Everett Mall Way Everett, WA 98204 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITV <br />ZIP <br />PHONE LICENSE+ <br />364-3600 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE+ <br />Shoreline Mech. Inc. <br />11735 15th Ave. NE <br />Seattle, WA 98125 <br />SHOREM116OBF <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE+ <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING rELOCATION <br />VALUATION OF WORK <br />S <br />DESCRIBE WORK <br />Gas piping for 6 roof top units. <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Retail <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 LOCALIL,REGULATING CONSTRUCTION OR <br />THE PE RAIANCON TRUCTION. <br />SIGNATU NT TQORI 0 AGENT. OR OWNER DATE p <br />X It - -p <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />JOB AOOREFS <br />1402 SE Everett Mall Way <br />PLUMBING <br />MEC ANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - A/HNDLG UNITS - H.P. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA, <br />LAVATORY (WASH BASIN) <br />BOILERS - B.T.U./H.P. <br />SHOWER <br />GAS FIRED ABC. UNITS - B.T.U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS -BT.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC.) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />_ <br />6 <br />GAS PIPING <br />4 <br />50 <br />EXHAUSTFAN <br />SUB TOTAL <br />$ <br />SUB TOTAL. s <br />4 <br />50 <br />PERMIT <br />$ <br />I• <br />PERMIT <br />15 <br />00 <br />TOTALFEE <br />$1 <br />TOTALFEE <br />19 <br />50 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑NO <br />FEES <br />VALUATION <br />I FEE <br />BUILDING <br />S <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />MECHANICAL <br />19 <br />50 <br />FIRE SPRINKLERS REQUIRED ❑YES ONO <br />INVESTIGATION FEE <br />Sec. Y04(e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APP (CATION ACC. BY <br />S.H. <br />PLANS CHECKED By <br />APPP. FOR ISSUANCE <br />BY <br />DRIVEWAY PERMIT <br />TOTAL <br />19 <br />50 <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />m <br />G� <br />Cn <br />r— <br />ADDRESS FILE <br />