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� <br /> `''eG1��TYo° CONSTRUCTIOP' <br /> e�erett PERMIT PERMIT NO. 116�.g <br /> CITY HALL 259�81d5 <br /> ev�aen.w�� snzo� ❑ COMBINAI'ION �CBUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OL4NlN T;re NAILAppRC$5 CIiY ZIP �'MONk ` <br /> United OK �y{.� Co. 2801 Rucker Everett 98201 259-9251 <br /> ARCHfCR OR DLSiGNER MAM1 ADDRE55 CILY 21P PMONE <br /> GCNERALCANiaPG10N MAILADDRESS Qiv LIP ���ONE IICENS[1 <br /> ;— Simco Sign Co. P.O. Box 68 ,:cerett 98206 252-0086 <br /> MLCMNtUChLCORiRAC10� MAILADDRE55 GtY ZIP CMONE UCEN.E� <br /> 1'WMBiNGGOHiRACiOR MnILAD�R[SS C'�tY ZIP PHONE LICENSE� <br /> CIA55 OF WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑R[PAIR ❑DEMOLI710N ❑FENCE �.'1$�GN ❑GARAGE <br /> VPIUAT10N OF WOFN <br /> S 86�. �� <br /> o�scaiee woaK <br /> inst.all illuminated sign <br /> rnoroseo use or ouaon�c <br /> I HEPEBY CERTIFY THAT I HAVE READ AND EXAMIKED THIS AR <br /> �ccn�oescwvnouoFvaor�ar.�s��owociowo�nnncnrouacovies� PLICATION 4ND KNOW THE SAIdE TO �E TRUE A.ND CORRECT. <br /> ALL PROVIS�ONS OF LAVJS AND ORDINANCES GOVERNWG THIS <br /> io* eiocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HER[IN OR NOT. THE GRANTING OF � PERMIT DOES NOT <br /> PRESUME TC GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> ' VISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING <br /> CONSTRUCT R TH RFORMANCF. OF CONSTRUCTION. <br /> JO�AUDRE55 SGNATUAL 0� �O4i TOP A �OR12ED PGENI OAiE <br /> 2801 Rucker X 3/15/83 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%7URE O�7 ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> VlAi[R CLOSET(TORET� AIf1 CONI) UNI15—HP EA. <br /> OATMTUB REFNIG'_RAiION UNITS—N.P.EA <br /> L�VATORV(WASH I3ALIN) BOItCHS—H P CA _ <br /> SMOWER G�5 FlR[D A.0 UNITS—TONNAGE CA. <br /> KITCHEN SINN 8 DISP. FORCED AIR SYSTGMS—�T U M EA. <br /> DISHWASH@R WALLHEAT6a5—BiU M <br /> LAUIJORY TRAV UNIT HEATLHS—�T U M <br /> CLOTH[S'NASHER EVAPORATN[GOOLERS <br /> WATER HEATER CIOTHFS DHVLRS <br /> URINAL V[NiPATION FAN _ <br /> DPINKING FOUNTAIN RANGE HOOD <br /> FIOOR DRAIN AIR HANDLING UNIT— G F.M. <br /> VACUUM�RFAKERS STOVE <br /> ROUF DRAMS—RAINLEADEPS METAL FlREPLACE 8 CHIMN[V <br /> SIbK(SERVICE—BAfl,ETCJ <br /> SUB TOTAL SUB TOTAI f <br /> PERMIT f PERMIT f <br /> TOTAL FF.E S TOTAL FEF. f <br /> SIDE YARD SETBACK STRE[7 SL7CACC REAP YAPD SET�ACK PLAN LHECK NUM�ER PLAN CHECK F[E <br /> FEe HECBPT NO. <br /> US[ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> IIVES I:NO <br /> iYP[OF CqNST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> OUILDIIJG g860.�0 6 �0 <br /> SIZE OF BLOG. NO OF S70RI[5 MA%.OCC LOAD <br /> PWMBING - <br /> — PIRE 20NE BASEME.'!? FlRE SPRINKLERS MECHANICAL <br /> PEOUIREO <br /> I YES I NO <br /> APPROVRLS BY DATE �THER <br /> 1. ENVINONI.�BNTALCHECKUST P[NALTY UDC <br /> SEC.393(a) <br /> 2. BUILDING PLANS <br /> I TOTAL 6 0 O <br /> 3. FIRP HVDRANT <br /> 4 FlR[PROTECiION SYSTEM PERMIT VFLIOATION <br /> 5. GRADING �'✓�{E�PROPERLV VALIDATED(M THIS S?�CE�)oH15 I£YQIARRE�MI� 0 — � <br /> yrb � iUU U <br /> 6. DflAINAGE � <br /> 7. ENVIRONMENTALIMPACTSTATFMENT � <br /> 8. HEALTHDISTRICT — �YO;U'R REGF!PT � <br /> pPPUCATION ACC.BY PU+NS CHECKED BV APPR FOR I$$UANCE BY T��/'\N K Y O U <br /> RF NV <br /> � � �t83 <br />