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���EWrom� APPLICATION �OR ���,�„ <br />��TM�F �ONSTRUCTION e <br />everett PERMIT <br />DEPT OF COMMUNI7Y OEVEIOPMENT SERVICES <br />CITY HALL 259�87�5 <br />EVERETT, WA98201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIII MUI �UUMISS CII� ZIP PNOY! <br />M�rNn�ir- V TNcmq•;� 8i�iol3cvci2�Y BcUD FucR<Tl, wN '�!�zc3 ii �,4�5; <br />ARrqp��� 00. �ISIGNI0. MAII �OUIIl55 ❑IY TIP INOMF <br />G(M11A1 CON111ACfOM MAII �DDRl55 ❑IT ZIP YMOMF llClNSf � <br />n11CN1hIUl(ON�qAC10M MF••D]IIISS ❑IV LIY PNONL IICFNS[I <br />PIP\Ifll\( NYIMA[IO� Mnll e0�M155 (111 IIp PHON{ IICINS[ � <br />l 1e55 U! NORk <br />❑NEW ❑ADDITION ❑ALTERATION �REPAIR �DEMOLITION ❑FENCE ❑SICN ❑GARAGE ❑BUILDING RELOCATION <br />Y� W AilOY Of NOMK <br />1 �SQ��•li/�/�%(cL _ <br />OISCRIB! WOxR <br />�,vS7ALL '�PI�C- t� ivsuLATEO w,�n:��s <br />>Aorosiousi oi nunomc I HEREBY CERiIFY iHAI I HAVE READ AND E%AMINED THIS AP- <br />U Wl O(SUIPIION Of YNOVIRIY pMONN 9llON ON �if�CN I011ll COVIISI <br />io� Z-� eia'K �? o� �LA�o F f�EVE/?LY /�A <br />iOP �OORISS <br />PLUMlING <br />��. TY�E OF FI%iUl <br />WATFN ClOSFT ITOLIFTI <br />BATNTUB <br />UVAT00.Y �WASN BASIN� <br />SHOWER <br />RIICHEN $INK b DISP <br />DISWASMfR <br />UUNORY TRAY <br />ClO1HF5 WA�MFR <br />WA1[X HfATEN <br />URINAL <br />�RINKING FOUNTAIN <br />FLOOR DNAIN <br />VACUUM ORFAKERS <br />RWf DRAINS—NAINLFADERS <br />iOTAI fEF <br />YARD SfiO�CK STNFfTS[Tfl/ <br />!OHE LOTAREA <br />Of CONSI OCCUPANCYI <br />AK�OVAl3 <br />1 ENVINONMENTALCHECKLIST <br />3 BUILDING YlANS <br />1 F�RE HYDNANT <br />1 f INF PROIFCTION SYSTEM <br />S GNADINU!%CAV�TIONBCLURINGILRI'OflINL <br />6 OP�INACF <br />7 FNVIpONMENTAI IMPACT $TATF.NFNT <br />E MEALTH DISTRICT <br />AP7lICATION ACC BY VUHS CHfCK[O BY <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 �OES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE Oli LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATU0.E Of CONiPACTOR OR AUTH00.1ZED AGFNT OATF <br />MfCHANIUt <br />NQ. iY/E Of FQUI►MENT <br />AIP COND UNITS—N P FA <br />RfFRILERATION UNITS—H P EA <br />POILERS—HP EA <br />CAS fIRFD AC UNITS—TONNAGE fA <br />fORCfDAIR5V5TEM5—BTU MfA <br />WALLME�TfRS—BIU M <br />UNIiMUTERS—PTU M <br />EVAPUR�TIPE COOLERS <br />CLOTHFS DRYFRS <br />VFNiIIATION fAN <br />NANG(MOOD <br />Alp NANDLING UNIT— C i M <br />STOVF <br />A[AM YARO 5l79ACK PUN CN[CK NUMBFR <br />VAUNf 511[ RFf <br />❑YES CNO <br />NO Of OWFIIINL UNIiS <br />BUILOINC <br />MA% OCC IO�O <br />PWMHINC <br />IIRF SPRINKLlRS <br />FFQUIR[D MECHANIUI <br />!�YFS f'NO <br />�Y DATF OTHlN <br />PENAITY <br />TOTAL <br />APiR fON <br />�E�MIT f <br />TOiAIiEF � <br />VUN CMFCK FfE <br />itF RFCEIPT NO. <br />VAIUATION IE[ <br />S <br />UBC <br />SFC XIJI�I <br />►FIIMIT VAIIDAiION <br />WN(N PpDPFNLY V�I IOATFD pN IHIS SPACE� THIS IS YOUR VERMIT <br />