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the Evergreen <br />^YONSTRUCTION <br />CITY <br />CITYOFF <br />everett <br />PERMIT <br />PERMIT NO.11492 <br />CITY HALL 259 8745 <br />r EVERETT, WA 98201 <br />❑ COMBINATION E3 BUILDING I_I MECHANICAL <br />LI PLUMBING <br />OWNER <br />MAIL ADDRESS .L1 <br />ZIP <br />NONE <br />George Shuh <br />2701 Walnut Everett <br />98201 <br />259-0814 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />NONE <br />cENER yerT Sign <br />ZPHONE <br />Vernon 98273424 -1325 <br />& Advertising RCo ADDRESS 1689 HighwayTY <br />99 Mt. <br />r MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />NONE LICENSE 1 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />NONE LICENSE F <br />L <br />L <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE &IGN ❑GARAGE <br />VALUATION OF WORK <br />f 1500.00 <br />TncMfll :11• .4..a <br />PROPOVO USE OF BUILDING <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 WHFTHER 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 COMPACTOR OR AUTHORIZED AGENT DATE <br />X Check # 2/7/83 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT BLOCK —OF <br />dpB PI'�iD`1 Walnut <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 />_ <br />BATHTUB <br />REFRIGERATION UNITS - H P. EA <br />I AVATORY (WASH BASIN) <br />BOILERS - H P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS -TONNAGE EA. <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA, <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - BTU M <br />:LOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <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.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE - BAR, ETC 1 <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />S <br />PERMIT f <br />TOTAL FEE <br />S <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 />AYES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S 1500. <br />9 <br />Be <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX. OOC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRED <br />❑YES ❑NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC. <br />. <br />SEC303(a) <br />2. BUILDING PLANS <br />TOTAL <br />9 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION S/STEM <br />5, GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMUT <br />9. _ <br />3 127 $ _� O O eO O c4 <br />E� Ey <br />IYO UfY RECEIPT <br />1 A AN 11 A'" YOU <br />i . <br />r THANK <br />) <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED B': <br />APPEL FOR ISSUANCE BY <br />ADDRESS FILE <br />- ] FEE S J <br />J <br />L J <br />