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CITY <br />everett <br />everett <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />CONSTRUCTION <br />PERMIT <br />EVERETT, WA98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIR MAIL ADURISS (TIT 11P PHONE <br />rl <br />OR <br />mall A"..", <br />ZIP <br />MICHANICAI CONTRA[ I OR MAIL ADDRESS CITY LIP PHONE LICENSE# <br />PI PSIBHG CONTRACTOR MAIL ADDRESS CITY LIP <br />PHONE LICENSE I <br />7 ail /✓7 u' <br />CI UA III WORK <br />❑NEW ❑ADDITION WALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />YveAnn%OF WORK <br />S 4;-fz* Fes' <br />III It FEEL WORK <br />FiVC ✓O.SG Z 7!�•. i, a <br />PRCIIAWIIF VISE OF <br />I I G AI INSCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH IOUR COPIES) <br />101 _BIOCK_ _01 _ <br />4 . "� <br />II IH ADDRI ^S <br />PLUMBING <br />r <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICAT ION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHI THER 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 />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FIE" <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSETITOLIETI <br />AIR COPIES UNITS -HP EA <br />BATHTUB <br />REFRIGIRATION UNITS-H P 1 A <br />IAVAIORV (WASH BASINI <br />'BOILFRS-H P EA <br />SHOW I R <br />GAS FIRED AC UNITS -TONNAGE EA <br />K17CHIN SINK 6 DISP <br />I CIRCE D AIR SYSTEMS-RTU MEA <br />OISWASHIR <br />WAIL HEATERS -BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS -BTU M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DKYFRS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS-RAINLEADI RS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICI -BAR. FTC) <br />SUB TOTAL <br />SUN TOTAL f <br />PERMIT S <br />PERMIT f <br />TOTAL FEE S <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK' <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES C� <br />TIES <br />VALUATION <br />FEE <br />TYPE /COyST <br />NN <br />OCCUPANCY CTUP <br />NO OF DWREING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />f <br />NO OF STORIES <br />/ <br />MAX OCC LOAD <br />Al� <br />PIUMBINC <br />FIRE ZONE <br />BASEMENT <br />HE UROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />nvFS (iFE/ <br />MICHANICAI <br />A►►ROVAL$ <br />BY <br />DATE <br />OTHIR <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />sc <br />SIC SfC bl(al <br />1 BUILDING PLANS <br />S FIRE HYDRANT <br />TOTAL <br /># FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACEI THIS IS YOUR PERMIT <br />S GRADING/! XCAVAT ION} CI E ARING/GRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT' STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPLE FOR ISSUANCE BY <br />9.1-79 <br />