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theE�'C�rOF CC ��STRUCTION � � � <br />everett PERMIT PERMIT NO.OH5S1 <br />CITY MALL 259�8745 <br />��:cNETf. WA 98201 ❑ COMBINATION �t BUILDING ❑ MECHANICAL ❑ PLUMBING <br />01YNEF MRRAUOqE55 GIiY ZIP FNON[ <br />Bliss Setter4ren (Totem Drive in) 4910 Rucker 98z01 252-3277 <br />ARCNIi[CT ON D[SIGNEP MNIL ApDRE55 C17Y ZiP PNpNE <br />GENERALCANIRRCTOR MAILApDRE55 LIiY ZIP VHONE lIC[NSEI <br />Riveraide Roof Company 2916 State Street Everett 98201 258-4646 <br />M[CNRNIC4LCANiMCTOR MAILADDRE55 CIiY ZIP RI _pnpry�R *3�yCEry$E} <br />Vk; VL'1'U <br />PlUM81NGfANiRACiOR 1Aq4ADDR[55 CITV ZIP PNONE UCENSE� <br />CtASS Oi WORH <br />❑NEW <br />VAIURTION OP WORN <br />S i�e2o.00 <br />re-roof <br />❑ADDITION ❑ALTERATION j�$REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />commercial <br />LEG4L DESGRIPTION Of PROPERTY �SHOW BELOW OR ATIAGN FOUR 1 <br />3ot-44 e1��oF Central Park <br />4410 Rucker <br />PLUMBINO <br />NO. TYPE OF FIxTURE O <br />WATER CLOSET (TOIIEn _ <br />BATMTUB <br />LAVATORY (WASH B�SINI <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTMES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAMLEADERS <br />SINK (SERVICE — BAR. ETC.) <br />_ SUB TOTAL <br />PENMI7 <br />TOTRL FEE <br />SI�E VARD SETBACK STREET SET�ACI <br />USE ZONE LOT AREA <br />TVPE OF fANST. OCCUPANCY GR <br />S12E OF BLDC. N0. OF STORIES <br />t ENVIRONMENTALCMECKLIST <br />:. BUILDING PLANS <br />3. FIRE HVDRANT <br />4. FIRE PROTFCTION SYSTEM <br />5, GRADING <br />6. �RAINAGE <br />Z ENVIRpNMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICAiION ACC. BV PlANS CHECKED UV <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLIGATION 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 WHETHER SPECIFIED <br />HER[IN 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 IOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SiGNATURE Of LONiNACNP OR AUI��ORIZEO AGENi DPTE <br />X Check #5008 11/17/80 <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />_ AIR COND UNIT$ — H.R EA. <br />REFHIGERATION UNITF — H.P. EA <br />BOIL[RS — H P. EA. <br />FORC[D`AIR SVSTEMS — BS'U ^V `^M EA. <br />YlALL NEATERS — D.T.U. M <br />UNIT HEATERS — O.TL. M <br />PANGEHOOD <br />REAHYAPD SETBACK PLAN CHECK <br />VACANT SITE <br />L'YES C]NO <br />MA%.00C.LOAD <br />APPR FUfl ISSUANCE BY <br />FEE I RECEIPT NO. <br />PUILnING I$2820.00 I 38 ISO <br />PLUMBING � <br />MECHANICAL <br />CTHER <br />PENALTY U.�C. <br />SEC.303�a) <br />IVIPL I I 38 I50 <br />PEPMIT VAIIDATION <br />WHEN PROPERLY VALIUATED (IN Tl115 SPACE) THIS IS YOUR PERMIT <br />0636 $0 �5.50 - �-+ <br />:.ri <br />,I. n:L(:��I p <br />� ., YCU <br />