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Qkc <br />the Evergreen <br />CITY OF <br />everett <br />CITIHALL 259-8745 <br />EVERETT. WA 98201 <br />`FIONSTRUCTION,-' <br />PERMIT <br />❑ C"', ABINATION 92 BUILDING ❑ MECHANICAL <br />1-\ <br />PERMIT NO. 06958 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Shell Oil Co. 9501 Bothell Way S.E. 337-5909 <br />ARCHITECT GI DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRAUL" <br />MAIL ADDRESS <br />CITY <br />IP PHONE LICENSEE <br />S. & S. Sign Co. <br />13190 Stone Avenue N. <br />Seattle <br />98�33 365-0242 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSEE <br />SS Si 60274CA <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CID <br />ZIP PHONE LICENSEE <br />❑NEW ❑ADDITION ❑ALTERA-ION ❑REPAIR ❑DEMOLITION ❑FENCE &IGN ❑GARAGE <br />VALUA'.ION OF WORK -- <br />s 500.00 <br />erect non illuminated sign <br />PROPOSED USE OF BUILDING <br />commercial <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 />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <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 PERFORMANCE OF CONSTRUCTION. <br />SIG1 LIRE OF CONTRACTOR OR AUTHOV D AGE^NT DATE <br />�r/U/7/ <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT BLOCK _OF <br />JOB ADDRESS <br />9501 19th Avenue S.E., <br />PLUMBING <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />_ <br />_ <br />AIR COND. UNITS — H P. EA. <br />BATHTUB <br />REFRIGERATION UN I ES — H.P. EA <br />LAVATORY WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — EFT U. M EA. <br />DISHWASHER <br />_ <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />UHINA, <br />VENTILATION FAN <br />DRINKING FOUNIAIN _ <br />RANGE HOOD <br />_ <br />FLOOR DRAIN _ _ <br />AIR HANDLING UNIT — CF.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />META!. FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUBTOTAL <br />SUB TOTAL S <br />PERMIT f <br />PERMIT $ <br />TOTAL FEE S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STPEET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACI J SITE <br />❑YE.. L'NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />I OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />1500.00 <br />5 <br />00 <br />SIZE OF BLDG, <br />I NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />DYES ONO <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 />5 <br />00 <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDAiEO (IN THIS SPACE) THIS IS YOUR PERMIT <br />p � <br />�i 9 4 d S 0 0 5. 0 0---,�,QQI <br />C-) <br />CD <br />Y0 U R RCS., G i PTo <br />THANK YOU <br />— — <br />5. GRADING <br />— <br />6. DRAINAGE <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION AC(:. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />BAB <br />