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MB Evergreen <br />CITY OF <br />everett <br />DEPT OF COMMUNITY DEVELOPMENT SERVIC <br />CITY HALL 259-874S <br />EVERETT, WA 98201 ❑COMBINATION <br />APPLICATION FOR EY�fe„ <br />CONSTRUCTION <br />PERMIT E+ <br />S <br />❑ BUILDING ❑MECHANICAL CPLUMBING PERMIT NO. <br />CLASS OF NCR <br />❑NEW )(ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />I I 000 <br />UI SI RIflI NORR <br />PgTyvos:ousl of xw INc <br />l ' <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION 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 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 PERF RMANCE OF CONSTRUCTION. <br />IGNATU F F C N(RACTOR OR AUTHORIZED AGENT ATE <br />SSI <br />A i <br />IIGAI DISCRIPIIONOI PROPIRIYISHO 'NRLION'OR AIIACFI FOUR COPIISI <br />IOT _H(OCK_OF <br />Q�/_ <br />��l <br />TOP ApOR�S J/ll �l <br />� (��/ <br />PLUMBING <br />MECH ICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WAI E R CLOSE T LTOLIETI <br />AIR COND UNITS —HP EA <br />BATHTUB <br />REFRIGERATION UNITS —HP EA <br />LAVATORY (WASH BASIN) <br />Cx7 <br />BOILERS --HP LA <br />SHOWER <br />Ck1 <br />GAS FIRED AC UNITS —TONNAGE EA <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS-0 T U M EA <br />DISWASHER <br />WALL HEATERS—B T U M <br />LAUNDRY TRAY <br />UNIT HEATERS —BTU M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM ORE AKERS <br />STOVE <br />POOF DRAINS—RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE —BAR. ETC) <br />SUN TOTAL <br />[Q% <br />SUB TOTAL S <br />3 <br />PERMIT <br />If <br />PERMIT 1 <br />TOTALITY <br />f <br />Ez <br />TOTAL F1E f <br />SIDf YARD SETBACK <br />STRI(TSETRACK <br />Z Of—T <br />RE AR YARD SE TRACK <br />Z Q/ter <br />PLAN CHECK UMBER <br />Q <br />PLAN <br />FEE y� <br />CHECK FEE <br />RECEIPT NO r <br />J <br />USE ZONE <br />_ ( <br />LOT AREA <br />VACANT SIT( <br />❑YES CFIO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />Y- 1\1 <br />OCCUPANCY GROUP <br />Ka <br />NO OF DWELLING UNITS <br />BUILDING <br />f Y <br />%(•XcNA-Y <br />�AJ.� <br />SI <br />,1ZE OF BLDG <br />Ac-L'7Ai7 JAF <br />NO Of STORIES <br />MAX OCC LOAD <br />— <br />PLUMBING <br />G <br />FIRE ZONE <br />-- <br />BASIMENi <br />_— <br />III LINIH)MS <br />Ij1(l- <br />'j <br />FIRE SPRINKLERS <br />R6QSIRE6<� <br />FlYf3 <br />MICMANICAL <br />Od <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I ENVIRONMENTAL CHECK LIST <br />PINALIY <br />URIC <br />SEC 1OXAI <br />2 BUILDING PLANS <br />TOTAL <br />1 <br />S FIRE HYDRANT <br />R FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLI VALIDATED DN THIS SPACE) THIS IS YOUR PERMIT <br />7 <br />�11 Z 'F� O I u E. o� 1 L_ (sA <br />S GRADINCIIXCAVATION 6 CLEARINGICRUBBINC <br />h DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />91 79 <br />