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the C•v <br />CONSTRUCTION <br />CITYOF <br />CITY OF <br />everett <br />PERMIT <br />PERMIT NO.10196 <br />CITY HALL 259-8745 <br />❑ COMBINATION RKBUILDING U MECHANICAL <br />❑ PLUMBING <br />EVERETT, WA 98201 <br />OWNER MAIL ADDRESS '1'1 <br />Carlson 6 Hopkins 513 1604 Hewitt Everett <br />ZIP PHONE <br />98201 258-2688 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE <br />Same <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE IICENSEI <br />PLUMBINGCONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE IF <br />CLASS OF WORK <br />❑NEW ❑ADDITION ALTERATION ❑REPAIR El DEMOLITION ❑FENCE ❑SIGN ❑GARAGE -- <br />$3500.00 _ <br />DESCRIBE WORK <br />Tenant improvements <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY TH :T I HAVE READ AND EXAMINED THIS AP• <br />office <br />AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />LEGAL DESCRIPTION OF PROPERLY ISHD'N BELOW OR ATTACH FOUR COPIES)P'-ICATION <br />ALI. PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <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 />CONSTRUCTION OR THE P RFORMANCE OF CONSTRUCTION. <br />SINNq URE OF CONTR TO DR AUT IORIZED AGENT DATE <br />JOB ADDRESS <br />2936 Wetmore Avenue 10th Floor <br />c 1/29/82 <br />PLUMBING <br />ME HANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />N <br />TYPE OF I.UIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — I .A <br />REFRIGERATION UNITS — H.P. EA <br />BATHTUB <br />BOILERS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />SHOWER <br />FORCED AIR SYSTEMS — DT.U. M EA. <br />KITCHEN SINK 8 DISP. <br />WALL HEATERS —B.T.U. M <br />DISHWASHER <br />I IYIT UFATFRR —RT.U. M <br />_ <br />VACI IUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />f <br />TOTAL FEE <br />9 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />USE ZONE <br />LOT AREA <br />DYES T SITE <br />NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />ND. OF DWELLING UNITS <br />SIZE OF BLDG. <br />FIRE ZONE <br />NO. OF STORIES <br />BASEMENT I <br />MAX. DOC. LOAD <br />FI Rb SoRINKLERS <br />n <br />I. ENVIRONMENTAL CHECK LIST <br />2, BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />G. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY I PLANS CHECKED BY <br />METAL <br />82/10194 <br />MECHANICAL <br />PLAN CHECK FEE <br />FEJ. 893 JiFCEIPE No, <br />VALUATION SbbU!EE <br />5 3500. 44 50 <br />BY DATE <br />PENALTY <br />TOTAL 44 50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />LO <br />r `e $044.5 <br />O <br />APPR. FOR ISSUANCE BY I . I <br />1� <br />7 <br />ADDRESS FILE <br />