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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />';ONSTRUCTION <br />PERMIT <br />❑ COMBINATION BBUILDING ❑ MECHANICAL <br />PERMIT NO. 09415 <br />❑ PLUMBING <br />OWNER MA'L ADDRESS CITY ZIP PHONE <br />Flame Tavern 4202 Rucker Everett 98203 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL AppRE55 <br />CITY <br />ZIP <br />98206 <br />PHONE LICENSE A <br />252-0086 <br />Simco Sign Corp <br />2719 Maple <br />Everett <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />SI <br />PHONE LICENSE F <br />MC OS C272P3 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />Z'P <br />PHONE LICENSE I <br />:LASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ](gSIGII ❑GARAGE <br />s 1400.00 <br />DESCRIBE WORK <br />Erect illuminated sign <br />PROPOSED 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 />LEGAL DESCRIPTION OF PROPERTY (SrOW BELOW OR ATTACH FOUR COPIES) <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT BLOCK —OF <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 />CONSTRUCTIO OR THE: PERFORMANCE OF CONSTRUCTION. <br />SIGNATUR TOR OR AUTHORIZED AGENT DAT <br />JOB ADDRESS <br />Y <br />4202 Rucker Avenue <br />X <br />CHANICAL <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR CONE. UNITS - H P. EA. <br />REFRIGERATION UNITS - H.P. EA <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />BOILERS - HP. EA <br />GAS FIRED AC. UNITS -TONNAGE EA, <br />SHOWER <br />FORCED AIR SYSTEMS - B T.U. M EA, <br />KITCHEN SINK & DISR <br />WALL HEATERS -BT.I M <br />- <br />DISHWASHER <br />UNIT HEATERS -B.T.U. M <br />LAUNDRY TRAY <br />EVAPORATIV[ COOLERS <br />CLOTHES WASHER <br />WATER HEATER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />URINAL <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT - C.F.M. <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR, ETC) <br />SUBTOTAL <br />!* <br />SUBTOTAL f <br />PERMIT <br />S <br />PERMIT <br />S <br />TOTAL FEE <br />i1 - <br />TOTAL <br />FEE <br />It <br />SIDE YARD SETBACK STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLr.N CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES FIND <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />s 1400. <br />9 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />DASEMENT <br />IRE SPRIN <br />REQUIRED KLERS <br />MECHANICAL <br />YES nNO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B.0 <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />9 <br />OO <br />3, FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />r <br />Q <br />C <br />5. GRADING <br />B. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />RF <br />BAB <br />ADDRESS FILE <br />