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(A�EvuOn�n APPLICATION FOR <br />CUNSTRUCTION °"�'°" <br />cin oF <br />e�verett PERMIT e <br />DEP7. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259�8745 <br />EVERET?, WA98i01 �COMBIN,ITION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWN[p MMInU�N[55 CRY 21p pNONE <br />GL-I-f/�Lu L� l= G✓i'S%a�JGL:1. „t SI 5' "' <br />.�.�t�� it•r� �au S� ;��N�ri�'= G✓;1. �!'.n - 0 3 3 3 <br />AqCH1TECT OR U[SIGN[R MAII nDDRF55 UTY sm e,....,. w, i_ .. __ . <br />/ ' _ <br />�.i e N S� <Ti.: s�%-C�.� 4", /.�c , i✓ is�7 S::c! /Sti2du + IS�vil i���(i �u.�v <br />o.�C` 97�I <br />410.ACION MAII AOOPE 5 CITY Ziy PIIONE IICENSE � <br />�=G/— <br />/CONTRnCiOfl MAlAOpNESS CIiY [IP PHON[ II�FNSE� <br />PWMpIYGCONiM�CIOP MAILADDNESS UtY ZIP YMONE llC[NSEI <br />un550f WORK <br />❑NEW �ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />�VAWATION OF WOAC <br />f e�/^�J � [%ii � � ry �') <br />D[SCMIO \VORK . <br />_S�Cur�� Si�.cy /.'il p, /�i� i) �tk IS i �r'r /�Gr C�.r� f <br />raovoseous[ ov nmiowc I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br />� di�tJS ci� �;3i-'%[.'�.'.p PLICATION AND KNOW THE SAME TO 0E TRUE AND CORRECT ALL <br />t[GAL OES[NIPiIONpf PROPlRTYISH014N 9[lOW OX qiA[H IOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNINC THIS TYPE <br />S� '��� �� IILG. OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />iot _LoiocK_or S 'G"/1/J� OR NOT. THE CRANTING OF A PERMIT DOES NOT PRESUME TO <br />�`_ � GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFCRM�NCE OF CONSTRUCTION. <br />SIGNATURE Cf CONTn�CTOR OR AUTM/OftIZED AGENT DAfE a• 1 S� �/ <br />ioenoon[ss `L�` X // (", .�1 /.. �� <br />�'�/�% 3 ��'r_;F' C',��;cs..� , <br />ALUMBING <br />NO. TYPE OF FIXTURE <br />IVAiER CLOSEi �T011Eil <br />I 9ATHTU� <br />� LAVATOHY�WASH BASIN� <br />SMOwFR <br />4 KITCHfN SINK 6 OISP <br />� DISWASMFR <br />IAUNDRYTPAY <br />CIOTHES wASNER <br />WATkR MEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DftAIN <br />VACUUM BREAKE0.5 <br />ROOF ORAINS–RAINLEA�ERS <br />SINK �SERVICE–BAR, f TC � <br />SU! IUTAt <br />►ERMIi s <br />USE <br />TYPE Oi CONST <br />a N <br />SIZE OF BLDG <br />100 g S•f. <br />LOT AREA <br />OCCUPAN[yLROUP <br />$2, �1, R� <br />NO. OF STORIES <br />Z <br />�� <br />APIIIOVALS <br />1 ENVIRn^:� :LNTAL CMECK LIST <br />2. 9UILDING PUNS <br />J fIRE MYDItANi <br />� FIRE PROiECTION SYSTFM <br />5 LRADINGE%CAVATIONBCLEARINGILRUtl91NC <br />L �NAIHAGF <br />7.f.NVIRONMENTALIMPACTSTATEMENT <br />E. HEALTN DISiAICT <br />APPUCATION ACC 0Y PUNS CHECKfD BY <br />TYpE OF EQUIPMENT <br />A�R COND. UNITS–H P. EA <br />REFRIG; RATION UNITS–H.P. EA <br />BOILERS–N P [A <br />GAS FIRED A C. UNITS–TONNAGE EA <br />fORCED AIR SYSTEMS–O.T U. M EA <br />WALI MEATEHS–�.T.U. M <br />UNIi''EATFRS-9TU. M <br />EVAPORATIVE COOLERS <br />CLOTMES OHYERS <br />VENTILATION FAN <br />RANGE MOOD <br />AIR MAN�LING UNIT– Ci M. <br />STOVE <br />MfTAL FBEPLACE 6 [HIMNFY <br />VA[ANT SITE <br />❑YES BIQO <br />NO.OF DWELLING UNITS <br />� eunoinc <br />MAX OCC IOAD <br />— PWn1tlING <br />FIRE SPRINKlERS <br />❑QS�R P/ MECHANIUL <br />F9A0 <br />/Y DAiE OTHEft <br />PENAl1Y <br />APPR FOft ISSU�NCf BY <br />SUl70TAL � <br />IfRMIT f <br />TOTALFEf 3 <br />NUM6ER PLAN CMECK FEE <br />FEE RECEIPTNO. <br />,;3�3� SaS��' <br />FFES VAlUAT10N FFF <br />s <br />UBC <br />SFC. )03(a) <br />0 <br />TO1Al I I • �4� I5� <br />►FIIMIT VALIDATION <br />WHEN PROPERLY VALIOATEDlIN THIS SPACE� TNIS IS YOUR PERMIT <br />