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- , <br /> 4 . <br /> � <br /> rheEvCRYOF "�� C�NSTRUCTION � � <br /> everett PERMIT PERMIT NO. OSS�s <br /> CITY HALL 259�P7a5 <br /> EVERETf.\YA 98201 ❑ COMBINATION I��UILDING ❑ MECHANICAL ❑ PLUMBING <br /> OIYNER MAILRO�RE55 CIIY 21F FNONC <br /> Up Date Business Dfachines 3018 Rucker Everett 98201 <br /> ARCMiECiORD[$IGN[11 MAILADDP[55 CIiY 21P PHONE <br /> OCNEfVAL CCHilIFCiOR A1RIL AbDRE55 piY ZIP PMONE LICENSE I <br /> Jim Manning and Assoc. F.dmonds 98020 774-1964 <br /> IALO�ANICAI CANiRACTOR M4:1 R�DPE55 CITY 21P PNONE LICENSE 1 <br /> JI MM AA #208MB <br /> VWMIlINGCANiRACiOR MRILRDDl1E55 CIiY 21P PIIONE IICENSEI <br /> GV.SS OF WORK <br /> ❑NEW OADDITION ❑AITER/,iION ❑REPAIR ❑DEMOLRION ❑FENCE �SIGN (�GARAGE <br /> \'PWAiIONOF WORN <br /> b 1� 0��. 00 <br /> DCSGRIBE WORN <br /> Install illuminated sign <br /> Paovoseo use ov em�owc <br /> I HEPEBY CERTIFY THAT I HAVE READ AND EXAMIIJED THIS AP• <br /> iecn�oEscaian�NOFraorcarrisNowouowoaarincrrouacorie:;� PLICATION AND KNO�.h' THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> io1 e�ce�oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONF OF ANY OTHER STATE GR IOCAL LAW REGULATING <br /> CONSiRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JOB RD�RESS SiCNAiU �-CON R iOHOR nUiHOqIZED AGENi pPTE <br /> 3018 Rucker Avenue X � � 11/4/80 <br /> �-_' C L-_. <br /> PLUMBINO MECH�N ��J� <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. % TYPE OF E�UIPMENT FEE <br /> WA?ER CLOSEf QOILET) AIR COND.UNITS—HP EA <br /> BATHTUB REFRIGERATION U111T5—N.R EA <br /> LAVATORV(WASH BASIN) BOIlERS—HP.EA. <br /> SHOWER G/+S FlRED AC.UNIiS—TONNAG[EA. <br /> NITCHEN SINN 8 OI5P. FORCCD AIR SYSTEMS—�T.U. M EA. <br /> DISHWASHER \YALL IiUQERS—U TL. M <br /> LAUNDRY TRAY UNI7 NEATERS—DSL. M <br /> CLOTHES WASHEfl EVAPOPPTIV[COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTIlA710N FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIF HANDLING UNIi— CF!A. <br /> VACUUM BREAKERS STOVE <br /> ROOF OHAINS—l7AWLEADERS MEIAL FlPEPLACE 8 CHIMNEI' <br /> SINK�SERVICE—DAR ETC) <br /> SUB TOTAL SUB TOTAL S <br /> PERMIT f PERMIT S <br /> TOTAL FEE S TOTAI FEE S <br /> SIDE VARD SETBACK STR[ET SETBACK REAR vARD SET�ACK PLAN CHECK NUMBER PLAN CNECK FEE <br /> FGE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> I7veS ['NO FEES VALURTION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP N0.OF DWELLING UNITS <br /> S�ZEOFBLDG. hO.OFSTORIES MA%.00C.LJAD BUIL�ING SZOOO. 00 G OO <br /> PLUtd81NG <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAI <br /> ❑vES ❑NO <br /> APPROVAlS ITY DATE OTHER <br /> 1. ENVIRONMENTALCHECKLIST pENALTY UBC <br /> 2. BUI�DING PLANS SEC.303(a) <br /> 3 PIRE HYDRANT TOTAL G OO <br /> 4. FIRE PROTECTION SVSTEM VER�'IT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SFACE)TH15 15 YOUR PERMIT <br /> 5. GRADING <br /> 6. DRAINAGE Q � � 3 � Q 0 6. 0 0 �N1 <br /> Z ENVIRONMENTALIMPACTSTATEMENT U7 <br /> B. HEALTH DISTRICT n � <br /> APPLICATION ACC.BY PU+NS CHECKED BV APPP.FOR ISSUANCE BV , � - � I. 1'.�,:C�I P� <br /> , �. � '.I�,� �ICU <br /> RB BAH , . <br /> ADDRESS FILE - I{ i;U� �� <br />