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the ERIEprRRn A[ -�' L I C A T I O N F O RRY�,E�IF <br />`Iry OF CONSTRUCTION n <br />everett PERMIT �J <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S9 8745 <br />EVERETT, WA9I2D1 ❑COMBINATION ,(BUILGING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />oWVIR MAIL ADIMFAA nll ilr rHo41 - <br />YMO\C• %%\n Co�Yy EYER�eg o\ '"%-,nr <br />ARCHAIC ORI SIC•dR MAR ADDFFFSS 1111 JIP rNONI <br />xnl (n`u Ne(FORT MAIL ADDRISS (nY �-A•^ TILD9T LIcFIRST 4 <br />�o V1��w�� �.o�o� OmA v,5c\-I\34 'A-\�-m ��aHo <br />.n111As1(AI I14IRA(IOR MAIL ADDRISS (AY !11 r11oVl IICtN511 <br />PITapM1C.(ONIRACIOR MAII ADDRISS IOV 71P PHON( UCt NSIa <br />I A,I III M(IRK <br />❑NEW ❑ADDITION ALTERATION []REPAIR ❑DEMOLITION ❑FFNCI: ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />SML7Vllt,%Ill NORA <br />IF 11 RIHI IIRI <br />\N�eR\*otz Re�ooe\ cF ��\S wG ���� oN 3Ro Lek <br />PRII,F DIM rn 11DIN(' <br />\,QN \CeS <br />I HIRLHY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO RE TRUE AND CORRECT ALL <br />PROVISIONS Of LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT DATE <br />I X� <br />II CAI DI S(R OPTION OI PROPI RTI DHOA%RHOA OR ATLAE11 FOUR COPE SI <br />- -11i 0Y� e�� �0��� R`/ ���Q��O��� <br />1—n101K_or Yt1yt <br />-\\-7\��� xy--y` �� �Q <br />1A O <br />II IT ADIIRF 11 <br />TF-\"v1o\ Rv o(i, I . <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPF OF FIXTURE <br />FEE <br />NO. <br />TvF F EQUIPMENT <br />FEE <br />WA I I R C L DST T I I OI If I I <br />AIR COND UNI7S-1IP IA <br />BATHTUB <br />RI I R ICE RAI ION UNITS - HP IA <br />I AVA TORY IW ASH BASIN) <br />BOICRS-HP EA <br />SHONIR <br />GASIIRIDAC UNITS-JONNACA[A <br />KIICIIEN SINK A DISP <br />IOR(I D AIR SYSIfMS-9 T U MIA <br />DISWASHIR <br />%%MI HI AIIRS-BTU NO <br />LAUNORN TRAY <br />UNIT FII ATIRS-111U M <br />CLOTHES NVASHIR <br />IS'APORATI%L COOLERS <br />WA7lR HEATER <br />(TOTEMS DRYIRS <br />URINAI <br />VINTILAIION IAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDIING UNIT- C F M <br />VACUUM BREAK[ RS <br />51011 <br />ROOF DRAINS-RAINLIAOIRS <br />MIIAI 11RIPIACf ACHIMNIV <br />SINK ISIRVIC( -BAR I IC ) <br />SUN TOTAL <br />SUR TOTAL f <br />PERMIT <br />S <br />PERMIT ! <br />TOTAL TIE <br />S <br />TOTAL FEE f <br />SIDI I-RDSi TRACK <br />STRHT SI TRACE; <br />PI AN NARO 5t 1BA( R <br />PI AN CHICK NUMBI R <br />PLAN <br />III 4 <br />CHECK IF[ <br />RECEIPT NO. <br />USE ZONt <br />107 ARIA <br />VACANT SIII <br />OYES ENO <br />TEES <br />VAIUATION <br />FEE <br />TVPI OF CONST <br />KFaAcoFt- <br />"f <br />FILL UPANCY CROUP <br />t3'L <br />NO OI DWELt ING UNITS <br />�-- <br />BUILDING <br />^/ <br />SLJ Cld <br />7 <br />OL <br />SIZE OF BLDGLDG <br />_-- <br />NO OF S70RI[7 <br />�.--� <br />MAX OCC LOAD <br />-- <br />PLUMBING <br />FIRE ZONE <br />-- <br />IIASIMINT <br />-- <br />I ILDROOMS <br />-- <br />IIRI SPRINKLERS <br />REQUIRED <br />nNts IS, <br />MIT HANTAL <br />A►►IOV. IS <br />IV <br />DATE <br />OTHIR <br />1 ENVIRONMENTAL CHICK LIST <br />FINAL IN <br />U BC <br />SIC WNW <br />2 BUILDING PLANS <br />- <br />— <br />TOTAL <br />0. <br />I FIRE HYDRANT <br />R FIRE PROTIC71ON SYSTIM <br />?LIMIT VALIDATION <br />WIT N PRO"[ RI Y VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADING K( AVAI ION A( L I AR INGIGRURRING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />I TH AITH DISTRICT <br />APPLICATION ACC BY <br />PLANSCHICKID BY APPR NOR %SLIkMI HN <br />