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thi• £��er,erecn <br /> �verett �� NSTRUCTI� �� <br /> PERMIT PERMIT N0. �5401 <br /> CITY HALL 259�87a5 <br /> EVERETT,WA98201 �] COMBINATlUN GY�c BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OYINER MAI�ApDRE55 CIfV ZIP .HONE <br /> Safeway Inc. #503 11031 State Road #527 Bverett 98204 745-2944 <br /> RRCMITECT OR�ESIGNER MAIL AD�FESS CIiY ZIP PHONE <br /> GENEPALWNTHlCTOR MAILADORESS QT1 ZIP PMONE LICENSE♦ <br /> Lull Inc. 4357 South 104th Place Seattle 98178 723-1888 <br /> MECHANIGAL GONTRACiOR MF:L ADOFE55 CITY ZIP PMONE UCENSE t <br /> LULL 343Q1 <br /> PLUMBING CONTRAGTOR IdAIL FO�RE:S CIfY ZIP PHONE LICENSE M <br /> L1A55 OF YJORN <br /> ❑ NEW ❑ ADDITION � ALTERATION ❑REPAIR ❑ DEMOLITION G FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALUATION OF WORK <br /> E 25�0��.�� <br /> .]ESCRIBE WORH <br /> 2 <br /> Install New Pish Department � <br /> � <br /> PROPOSED USE OF BUILDING n <br /> Retail Sales I HEREBY CERTIFY THAT I HAV'� READ AND EXAMINED l'HIS m <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND �� <br /> LEGAL DESCRIPTION OF PflOPERTY�SHOW BEIOW OR ATTAGM FOUR LOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or_e�ocK_oc GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH -+T <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GAANTING OF A �..� <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE �^ _ <br /> m <br /> OR CANCEL THE PROVISIONS OF ANV OTHER STATE OR � a <br /> LOCAL LAW REGULATING CONSTRUCTInN OR THE mo <br /> _ __, PERFO NCE OF CONSTRUCTION. „�� <br /> JOBADORE55 SIGN CONTRACTO THOR�F GENT DATE O 3 <br /> 11031 State Roacl 527 ( � 9�9/85 ,..�z <br /> x--i <br /> PLUMBING N,ECHANICAL m ,.., <br /> - A z <br /> N0. TYPE OF FI%TURE OH ITEM FEE N0. TYPE OF EQUIPM1IENT FEE a � <br /> WATER CLOSET�TOILEn AIR COND. UNI7S - H.P. EA. r S <br /> _ i--i r-. <br /> BATHTUB REFRIGERATION UNITS- H.P. [A. "'�N <br /> K <br /> LAVATORY(WASH BASIN) BOILERS- H.P. EA. T� <br /> O A <br /> SHOWER __ GAS FIRED A.C. UNRS-TONNAGE EA. T 3 <br /> KITCHEN SINK 8 DISP. __ FORCED FIR SYSTEMS- O.7.U. M EA. =m <br /> DISHWASHER YlALL HEATERS- B.7.U. M m"" <br /> N <br /> I.AUNDRY TRAY _ UNIT HEATERS- B.7.U. M O r <br /> CLO7HES WASHER EVAPORATIV"e COOLERS n m <br /> C N <br /> WATER HEATER CLOTHES DRYERS m N <br /> UqINAL VENTILATION FAN = n <br /> —i r <br /> DRINKING FOUNTAIN RANGE H000 r^ <br /> D <br /> FLOOR ORAIN AIR HANDLING UNIT- C.F.M. � <br /> VACUUM �REAKERS STOVE- WOOD '� <br /> _ S• <br /> ROOF DRAINS- RFINLEADE:�i MF:TAL FIREPLACE 8 CHIMNEV D <br /> __ 2 <br /> SINK(SEPVICE- BAR, ETC.) FIREPLACE INSERT � <br /> HEAT PUMP F=„ <br /> N <br /> Z <br /> O <br /> --� <br /> _ _ � <br /> SUB TOTAL S SUB TOTAL S n <br /> _ m <br /> PERMIT 5 PEFMI7 S <br /> TO7AL FEE S TOTALFEE S <br /> SI�E YARD SETBACK STREET SETBACK REAR YARU SETBACK PLAN CHECK NUI.IBER PLAN CHECK PEE <br /> N/A N/A N/A <br /> SS��.S4OI. FEE 110.2�3 RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SI7E — �-�cjaqq <br /> B-2A N�A ; �YES .�GYO FEES VALUATION xEF <br /> TYPE OF CONS7. OCCUPANCY GROUP NO.OF DW[LLING UNITS <br /> V-N B-2 — — <br /> RUILOING g 25,000. 17060 <br /> SIZE OF BLOG. NO.Of STOFiIES M1fAX.OCC. LOAD - <br /> N�Il 1 N/A PLUMBING <br /> FIME ZONE BASEMENT FIRE SPRINKLEflS MECHANIGAL <br /> REOUIRED <br /> YES ._NO <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIFONIAENTAL CHECK LIST pENALTY U.B.C. <br /> SEC.303(a� <br /> 2.BUILDING PLANS <br /> 3.FIREHYDRANT TOTAL 170 BO <br /> 4.FIRE PROTEGTION 51'STEM PERMIT VALIDATION <br /> 5.GRADING _ WHEN PROPERLY VALIDATC-D(IN TH'SfJ iAOE)THI$II � OR POERMIT � <br /> 6.DRAINAGE � � '� Q <br /> 7.ENVIRONMENTALIMPAC7STA7EMENT � <br /> 8.HEALTH DISTRICT <br /> APPUCATION ACC.BY PLANS CHECKED BY APPR. FOR ISSUANGE BY YO U 12 f:�C E I PT � <br /> JEF - , .. .��•��. '��C) U <br /> AUDRcSS FP.E � � ��P �) <br />