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_ APP ICATION FOR everetl <br /> C STRUCTiON � e <br /> everett PERMIIT <br /> OEPT. OF CO.ti1MUNITY D[VELOPh7ENT SERVICES <br /> CITY HALL 259-8745 <br /> EVERETT,N'A9B201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> ownte nuu nooetss air zir rnon�[ <br /> �JLP�NE 7SiC'C .S/1LF`� 5'�R'o5 F--Uc�2G�2T'c's✓ a���-r S. .-'vIT 9$'Zo� �-,�2 –'f/87 <br /> AHCIIIiECT ON 061GNER MAII ADURESS CITV ZIP PHONF <br /> G[N[RAl CONiNAR08 AUIL ADDRFS$ CRY 7.IP PHONE IICENSE/ <br /> ;,',cur.'y• X.ci^ti' �G.0 oo� .7 oa7 f / s� �✓� c3G 77< EE=,,." srct. 6-50 , <br /> — ! /' YN�/ c.�H `'i S' <br /> MEOInNiUL CO4iR�C10R na!I AOUR6S ❑TY LIP PH04! LKENS[k <br /> PlUn1pINL COYiRAQOR _— AUII A�OPf55 UTY ZIP PHONE LKENS[Y <br /> Qn55 OF\40FA <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑D[MOLITION ❑FENCE ❑SIGN ❑GARAGE ❑DUIIDING RELOCATION <br /> V,1lU�T10N OF\VORK <br /> 3 �f s� da <br /> . <br /> o�scxioe wokK <br /> i � <br /> �rr����r �<�'; si;.:•-i r�'S' )CI7� Il�F >�:.. r c.. •�f�i ew � X20�{�i= L-n'6c .`�16:v <br /> rxo osmus� oruuno�nc ' I HER[6Y CERTIFY THAT I HAVE READ AND EX�MINED THIS AP- <br /> GC�%'� ��'/-`- ��'.1 l��. PLICATION AND KNOW THE SAAIf TO 6E TRUE nND CORRECT ALL <br /> iFcni oisceirnouov raorFFrrivrowr+uuowoknruoi wuacoricsi PROVISIONS OF LAWS �ND ORUI'�ANCES COVERNING THIS TYP[ <br /> OP WORK WILL 6E CO�b1PLIED L+ITH WHETHER SPECIFIED HERFIN <br /> ior n�orK_ar -. OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTFIORITY TO VICLATE OR CANC[L THE PROVISIONS Of- <br /> ANY OTHER STATE OR LOCAL L�W R[GULATING CONSTRUCTION <br /> OR TH[ PERFORMANCE OP CONSTRUCTION. <br /> SIGNAIURE F CONTNACTOR OR AUTHORIZED AGENT UATE <br /> / <br /> IOIi AODRESS /� J� <br /> �G.�( . 1:'' • . ' ' �' - X � ' �f � �/ -. � ���f C� <br /> , _ y <br /> PLUMBING MECHAM�CAL <br /> NO. TYPE OF FIXTURE FEi NO. TYPE PF EQUIPMENT FEE <br /> lt',\TER CI.OSFT(TOLIET) AIH COND. UNITS—H P. EA <br /> BATHTUO NFFNIGENATION UNITS—HP.CA <br /> LA\'ATORYpYASH f7A51N� 60RER5—HP. EA <br /> SHGWFR GAS fIRLD�\C.lIN1T5—TOtip'AGC EA <br /> KITCH[N SIhK 8 OISP �ONCCD•�IN SYSTkMS—OS U. M EA <br /> DISLVASHER N'nLL HLATEHS—U.TL. M <br /> LnUNDRY TRAY UhIT HfnT[RS—[1.T.U. M <br /> CLOTHES WASHEH CVAPORA7IVE COOLERS <br /> WATEN HCnTEN CLOTHkS DRYkNS <br /> URINAL VLNTILATION PAN <br /> DRINKINC FOUNTAIN RANGE HOOO <br /> FLOON DNArv qIR HM'�IJNG UNR— C EM. <br /> V'ANUM UREAK�FS STOVC <br /> ROOF DRAINS—RAINIFADERS nt[TAL FlREF'�nCE&CHIMNFV <br /> SI4K(SERVICF-6AR,(TC) <br /> SUBTOTAL SUB70TAL f <br /> PERMIT S PERAIIT f <br /> TOTAL FEE f TOTAL FFE S <br /> SIDE YARD$ET�AIX STRE[1 SETB/vCK RfAii\'ARD SLTl1ACK PIAN CHECA NUMIl6R PLAN CNECK FE[ <br /> FkF RECEIPT NO. <br /> US[ ZO�'�'I LOT ANU ' VACn^li SITE <br /> ❑YES 'lN0 FfES VAWATION FEE <br /> TYPL Of COYSi. OCNPANCY GROUI' NO.Of DWII.IJNG UNITS <br /> IfUILDING 5/��� �J �. �O <br /> 517.0 Of I1tOG NO.OF STORIE$ �VA%.OCC LOAD "�� <br /> PI.U.4IIIINC <br /> FIRF ZO�C �ASCMENT IIkUftUO�Vti FIHC SI'RINKLFNS ' <br /> REQUIHFD A1fC11ANIUL <br /> I IYfS [1N0 <br /> APPROVALS BY UATE OTHEN <br /> 7 ENVBONMkNTAL CHLG: LISi U��� <br /> PLNALTV SkC. 3071a1 <br /> ?. GUILDING PLANS <br /> J FlR[ HI'URANT iOTAL 5 �U <br /> J. PIRF PROTECT104 SYSTEM PERMIT VALIDATION <br /> K'IICN PROPFRL7 VALIDnTED ON THIS SPME)THIS IS YOUN PERMIT <br /> i GRADINf.:lk(A\'A710NACLIANING/GHUIf111N(. ,� <br /> '' °k"i""c` f L' Gl'.> ELCG72/Gd L <br /> 7. lNb9HJNMENTAI.IMPAC� SIATEVEN� <br /> B HEAITH OISiRICT <br /> APPLIU110N ACC 11Y PIAN$CHKKCO IlY �PPH I R ISSU�M1(.' 'lY <br /> �� �' !d%_ J 1DQ-,fi' <br /> /I. <br /> ��� �2 t/�'j��'i�i <br /> e-,a�, <br />