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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT, WA 98201 <br />4PONSTRUCTI016 <br />PERMIT PERMIT NO. 16368 <br />❑ COMBINATION GCI BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER <br />Time Oil Co. <br />MAIL ADDRESS <br />2737 W. Commodore Way Seattle, <br />CITY ZIP <br />WA 98199 <br />PHONE <br />285-2400 <br />ARCHITECT OR DESIGNED <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />..TAIL ADDRESS <br />CITY <br />21P <br />PHONE LICENSE <br />Williams &Abbott <br />Const. 14712 Bothell Way NE <br />Seattle, WA <br />98155 <br />365-6800 <br />MECHANICAL CONTRACT OR <br />MA ,ADDRESS <br />CITY <br />ZIP <br />HONE LICENSE <br />223-01-WI-LL-lA-C 202 PT <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE 1 <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION <br />Ek ALTERATION ❑ REPAIR ❑ DEMOLITION <br />❑ FENCE <br />❑ SIGN <br />O WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />s 4000.00 <br />DESCRIPE WORK <br />3' doors at public <br />restrooms, relocate entry doors, <br />remove some <br />interior nerY;t;nn uaTTc <br />PROPOSED USE OF BUILDING <br />Dept. of Licensing <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 />SIGNATU F CONTRACTOR OR AUTHORIZED AGENT DATE <br />X 4/4/86 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />12,13,14,15&16 <br />LOT _BLOCK _rOF E!riday's__h*_t__Addto City <br />of Everett <br />JOB ,OGRESS <br />353E Rucker Ave <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EGUIPMENT F FEE <br />WATER CLOSET JOILET) <br />UNITS - H.P. EA. <br />BATHTUB <br />TION UNITS - H.P. EA. <br />LAVATORY (WASH BASIN <br />H.P. EA. <br />SHOWER <br />A.C. UNITS - TONNAGE EA. <br />=B.T�U,M <br />KITCHEN SINK A DISP. <br />R SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />ERS - B.T.U. MLAUNDRYTRAY <br />ERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <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 - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT S <br />PERMIT S <br />TOTAL FEE S <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />N.A. <br />STREET SETBACK <br />N.A. <br />REAR YARD SETBACK <br />N.A. <br />PLAN CHECK NUMBER <br />86/16368 <br />PLAN <br />FEE 28.93 <br />CHECK FEE <br />RECEIPT NO. <br />79592 <br />USE ZONE <br />R-4 <br />LOT AREA <br />N.A. <br />VACANT SITE <br />YES X NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />Bma B-2 <br />NO. OF DWELLING UNITS <br />0 <br />BUILDING <br />$ 4000.00 <br />44 <br />50 <br />SIZE OF BLDG. <br />N.A. <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />N.A. <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />44 <br />50 <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IiS,Yquj PFJIT <br />11 - CL7J <br />M <br />I <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />M.M. <br />PLANS CHECKED BY <br />J.E.F. <br />APPR. FOR ISSUANCE BY <br />L.C.I <br />I <br />ADDRESS FILE <br />