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A�PLICATION fORr� ��«<n <br /> '".E"ro'"° ..ONSTRUCTION e <br /> cm or <br /> everett PE RFv11T <br /> DEPT-OF COMMUNITY DEVELOPMENT SERVICES ' <br /> CITY HALL 25487l5 <br /> EVERET7,WA9E201 ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMSING PERNIT NO. <br /> _ OWM1�`� '�M���II AOOP[55 CITY ZIP PNONF <br /> / � ti� �� � ' i � v i '� � V' _ <br /> �lCMR(CTORDl51GM(� M�IIAODl165 CIfY 211 h10NE <br /> GEN[IIAtCOYTMCTOII m�ILNOOF[SS CIt� ZIP /NONE 4C[MSEI • <br /> M[CM�MI[Al CONtIl�CTO� MMl�DDR6S CIT� LV PMOME UC[NSF 1 <br /> , P�pM91YG CONT6�CiOR M�II�DDR65 G1Y 21I PXOMF IICEMSE I <br /> C1�55 01 N'OIIF <br /> ❑NEW ❑ADDITION ❑AITERATION ❑REPAIR �OEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUII�ING RELOCATION <br /> V�IUAiION O(WORK <br /> t <br /> D(SCR [WORk / <br /> �� i,->a// �v —� �c.. � ir i» <br /> vxoroseo uu or euno�uc ��� I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br /> j xj ��p� � 7 p I��T�uf�/T PLICATION AND KNOW THE SAME TO BE TRUE AN��:.RRECT ALL <br /> LLGAI OfSCMIV110HOf VROP[0.1YISMOWNBIIOW OR�1i�CN 10U�COPl61 PROVIS�ONS OF LAWS AND ORDINANCES GOVL"RNING THIS TYPE <br /> O�WORK WILL BE COMPLIE�WITH WHETNER SVECIFIED HEREIN <br /> ioi �_eioca�_or OR NOT. THE CRANTING OF A PERMIT DOES NOT PRESI�ME i0 <br /> G�VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOUL UW REGULATINC CONSTRI:CTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> 3� O S � �� � C��,L,�T SILNATURF OF CONiNACTOR O ORIZ[D AGENi DAiC <br /> IOBR000.[55 �--���_ C/�iP �/ <br /> ►WM�ING MECMANICAL <br /> NO. TYrE OF il%TURE FEE NO. TY►E OF FQUI►MENT FEE <br /> N'AifFCl05[T�IOLIETI �INCOND UNITS—HP FA <br /> BAINTUB 0.[FRIGI RATION UNI75—H P (� <br /> UVeTORY(WASHBASIN� BOII[RS—MP �� <br /> SIIOK'!N WS fBEDAC UNITS—TONNAGE EA <br /> KITCNINSINK6015P iONC[OAIR5�51[MS—BTU MG <br /> DISN'ASN[R WAllHN7LR5—BTU M <br /> UUND0.Y TRAY UN17 MUTEflS—B T U M <br /> CLO1Hf5 WASHFR LVAPONATIVE COOI[RS <br /> N'�il X Hf ATlN CIOTNf S�MY!RS <br /> URINAL VLY71U110N fAN <br /> DRINKING FOUNTAIN RANGF HOOD ' <br /> fIOOR ORAIN AIN MANOLING UvIT— C i M <br /> VACUUM BRF�K[MS �TQ�E <br /> ROO/DRAINS—NAINLUOfRS METAL FlREPUCF 6 CHIMNfY <br /> SiNK 6[NVIC[—BA0.[TC� <br /> SU�TOT�t SU�TOTAL � <br /> ►[�MIT t ►[�MIT � <br /> TOT�L ff[ 1 TOTAL iF[ � <br /> SID! Y�0.0 SRBACK STRI[T$LTflACK NUN YAND SITBACK PLAN CH[CK NUMB[R PUN CHFCK Ff[ <br /> Rf R[CFIPT NO. <br /> VSf ZONE lOT ARU VACANT SRF ���y VAIU�TION IF! <br /> OY[5 CNO <br /> TYPE Of CONST OCNPANCY GHOUV NO OF OW[LLING UNIiS <br /> BUIIDING � <br /> SIZE Of BLDG NO OF STORI6 MA% OCC IOAD <br /> PWMBINC <br /> {Ip[ 20NE BASEMENT BLUPOOMS R[QUB[fDKL�RS M(CMANIUL <br /> ❑Y(S (7N0 <br /> AR�OV�It �Y OA7[ QTHE0. <br /> 1 [NVINONM[NiAICMICKl15T P[NAL7Y UBC. <br /> 5[C lOHel <br /> 2 BUILDINC PUNS <br /> TOtAI <br /> 3 fIR[ MYDRANT <br /> � flq[ PNOT[CTION SVST[M ►[IIMIT V�UD�iION <br /> WNEN PqOP[RLY VALI�ATED IIN THIS SPACq TN1515 YOUR P[RMIT <br /> S GRADINGLXCAVATION6CLURINGGRUBRING <br /> 6 ORAINAGE <br /> L [NVINONMENTAI IMPACT$TAIEMENT <br /> E H[ALTH D157H�Ct <br /> APPlIUT10N ACC.BY PUNS CHEIXED 6Y APPR (OH ISSWNCf BY <br /> 9�7�79 <br />