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the Everg eeen n , .O N VT R IJOI <br />CITeverett PERMIT PERMIT NO.06958 <br />CITY HALL 259-8145 <br />E/ERETT, WA 98201 ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY Zip PHONE <br />Shell Oil Co. 9501 Bothell Way S.E. 337-5909 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />IP PHONE LIC'ENSE1 <br />S. & S. Sign Co. <br />13190 Stone Avenue N. <br />Seattle <br />9853 365-0242 <br />MEC:IANICAL CONTACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE <br />SS SI 60274CA <br />PLUMBING CONTRACTOR <br />MAIL DDRESS <br />CITY <br />ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE k;�I(N ❑GARAGE <br />VALUATION 09 WORK <br />S 500.00 <br />DESCRIBE WORK <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 I f"RFORMANCE OF CONSTRUCTION. <br />SIGI URE OF CONTRACTOR OR AUTHOFfjD AGENT DATE <br />// / 57/% <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 />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />_ <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY (WASI I BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />_ <br />CLOTHES WASI.'R <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING rOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C F.M. <br />_ <br />VACUUM BREAKE'IS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SEP' CE — BAR, ETC.) <br />SUB TOTAL <br />SUE TOTAL $ <br />PERMIT <br />$ <br />PERMIT f <br />_ <br />TOTAL FEG <br />$ <br />TOTAL <br />_ <br />FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />'LAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />BUILDING <br />$5000T <br />5 <br />00 <br />SIZE OF BLDG. <br />N0. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REOUIRED <br />OYES ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />i <br />T. ENVIRONMENTAL CHECKLIST <br />PENALTY <br />U.B.C. <br />SEC. 303 To) <br />POO <br />2. BUILDING PLANS <br />TOTAL <br />5 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />— <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />4 9 9 E $ 0 05.00 ---.9, <br />Q7 <br />er T(0 <br />YO U' R REC E Ip+c—) <br />THANK YOU <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. aY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />BAB <br />ADDRESS FILE 19 NOV 79 <br />