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A LICATION FOR <br />NSTRUC PION i e <br />everett PERMIT <br />III PT 01 (OMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 1598745 <br />I VFRETT, WA 98101 ❑COMBINATION BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />UWNFR MAIL 40ORIll CITY ZIP PHONE <br />ANCHH[Ci0 lStGN[R MAIL ADDRESS CITY ZIP PHONE <br />C111 <br />mnn noonu> <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONI IICLNSFR <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION XREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE 08111LDING RELOCATION <br />VALUATION Of WORK <br />OIS('RRIIB'? <br />E WORK / w p-P `ra... <br />)`L%l4 /Jn/w �{�J I/h <br />MO"F0 US1 Of FIUROING'p <br />YL"S/Y/G1^ <br />I HEREBY CERTIFY THAIVI 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 PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />7 <br />x wry <br />I ICAI 01 SC R IPT ION Of PROPS R TY(SHOWN BELOW OR ATTACH TOUR COPS SI <br />"IT 91CICK-0f <br />R/ / <br />A- / rlV <br />IItnA�R[S!�/�/%%7A-)h i �vve %J) <br />- s , <br />PLUMB)NG 3:� 5 -CLy� <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FIT <br />IYA TF R CLOSE T(TOI IF II <br />AIR COND UNITS-H.P IA <br />IN I TUB <br />RLFRIGFRATIONUNITS-HP FA <br />IA% ATORYIWASH BASIN) <br />BOILERS HP FA <br />SIIOWFR <br />GAS FIRMA( t'NITS-IONN'AM IA <br />KITCHEN SINK A DIM' <br />FORCFO AIR SN5IIM'\ -H 11' MIA <br />OIS'NASHIR <br />WALL WATERS -II I Ll SI <br />LAUNDRY TRAY <br />UNIT HEATERS-fl T U m <br />CLOTHES WASHIR <br />IVAPORATIVE COOLERS <br />WATER HEATER <br />CIOTHFS DRYERS <br />URINAL <br />VI NTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- ( I NI <br />VACUUM BRIAKINS <br />STOVF <br />ROOF DRAINS- RAINS I A()1 NS <br />MI TAT FIREPLACE A CIIIMNI I <br />SWK(SIR%HI -HAR III <br />SUN TOTAL <br />SUB TOTAL s <br />PERMIT <br />N <br />PERMIT S <br />TOTAL FEE <br />• <br />TOTAL FEE S <br />SIDE YARD SF TRACK <br />STRIII St TRACK <br />BUR YARD SIIOACK <br />PI AN CHECK NUMBER <br />I'l AN (HICK HE <br />fit RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YFS nNO <br />FEES <br />VALUATION <br />IFS <br />TYPE OF CONSE <br />OCCUPANCY GROUP <br />NO Of DWI U ING UNITS <br />BUILDING <br />S It cgs <br />1 <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />NUMBING <br />FIRE ZONE <br />BASEMENT <br />I ITT DR(N)AI% <br />FISH SPRINKIIRS <br />REQUIRED <br />I'YIS (11,10 <br />AILCHANICAI <br />APPROVALS <br />BY <br />DATE <br />OIIII R <br />1 fNVIRONABF.fALCHICKIISl <br />PI NAI IY <br />UPC <br />SEC. 703(/) <br />2 BI!II O;NL 1'I Akt <br />TOTAL <br />IZ <br />l SIRS f11DRANT <br />A IINI I'ROII( THIN SYSIIAI <br />PERMIT VALIDATION <br />WHEN PROM RLY VAL IDATE D (IN T1EIS SPACE) IHIS IS YOUR RHEIMS1 <br />5 LN Aiutil.I>I Al AII'iNA(11ARINC,IGRLJRIRN', <br />6 DNAIN AI,I <br />7 I N% M(INMI N 1 AI IMPACT STAU MF NT <br />R IIIAI111 DISTRI( I <br />APP::ATION ACC NY <br />PLANS CHl CKFD flY <br />AI'I'R TOR ISSUANC'I BY <br />