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` <br /> � <br /> IMEmpmn APPLIC��'i0�1 FOR lverNl <br /> ��TM� CONSTR�JCTIOh � <br /> everett PE RM IT <br /> DEP7 OF COMMUNITY DEVELOPMENT SERVICES <br /> CITV -IALL :5°-9795 <br /> EVEREiT,WA9B201 []COM8INATION ❑ BUILDING ❑ME�HANICAL ❑PLUMBING PERMIT NO. <br /> � owr.ta M�n.00kEss arr zir /�diNE S!f°P/�G <7YG <br /> f�/dZ7Z ��vY�S `f 90 3 EVE�2G�2�'N w1rY EUIT �.•H, � � <br /> ARCMIi[Ci OR OESIGNER M�It AL�RE55 CIIY ZIP PHONE <br /> G[HFXAI COVIRACiOR MAII AD00.65 CILY ZIY VMONE IICFNSE I <br /> /,�eilaY,vEu.uca,nvc, iic�� G/Zrt/� LYr✓�'�G�N QTd3G 77G $S3� �''�v CIEKRYN1�f7U7. <br /> A1(qU�i[�.l CONIR�CIOR MAI��OONE55 � CIIY CIP PNONE IICEN$[I <br /> 1 <br /> YlL!Npltif.fONiRACL00. M�II AO�RF55 CIiY ZIP PHONE IICFNSE I <br /> CUSS Of wONK <br /> ❑NCN' ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE �SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> vewenov or��ezR <br /> t <br /> �� 00, �= <br /> � <br /> oiscuin[woax <br /> C/'J2e�T d-i��PTN7'�F.TiY �t ,3 ��C/S� S� S26N .�.v7Z=2Zt�2 �c.✓�*+, !{ao . <br /> F �k.r.Jf <br /> vaovouovsE oi dunowc I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED TFilS AP- <br /> lUrv`wr�,�c�qt S�csN, PLICATION AND KNOW 7HE SAME 1'O BE TRUE AND CORRECT ALL <br /> IEWI OfSCRIPIIOV Of PPOP[R1Y�SIIONN REIOW OM AIiACM fOUR COP:E51 PROVISIONS OF LAWS AN�ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ioi _aioca_or OR NOT. THE GRANTING OF A PERMIT UOES NOT PRESUME TO <br /> G�VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �NY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> , OR TNE PERFORMANCE OF CONSTRUCTION. <br /> SIGNAIURE OF CONTRA!'TOR OR AUTHORIZED AGEIiT DATE <br /> � ION ADDRf 55 � _� ^ b� <br /> , �f�10 3 � �c—� 6��,,, �.�-s; x ��_= o <br /> PLUMBING MECHINIUL <br /> jF NO. TYPE OF FIXTUNE FEE NO. TYPE OF EQUIPMENT FEE <br /> I 1VA7FR CLOS[T�TOLIETI ��H COND UNITS-H P EA <br /> � OATHTUD MEFRIGfHATIONUNITS-HP EA <br /> U\'ATORYIWASHBASIN� DPILFkS-HP EA <br /> ISHOWFR GASFI0.E�AC UNIT$-TONNAGEEA <br /> KITCM[N SINK L�ISP IONCED A�R SYSTEM$-tl T.0 M EA <br /> DISwASHER �vAILHEATERS-OTU M <br /> t�UtiGRY TRAV U�'li HUifRS-11 T U M <br /> CLOIHES`NASMER EVAPORAll1'I COOLERS <br /> N'ATER HEATEH CIOTHES ORYFRS <br /> URINAI Vf NTIUiION FAN <br /> UNINAIYC FOUNiAIN RAKLE HOOD <br /> FLOOP ORAIN AIR HANDI�NC UNIT- C F M <br /> VACUUM ONE�KERS STOVE <br /> ROOF ORAInS-RnINIEAOkRS METAI FINEPLACF A CMIMNfY �_ <br /> SINK(SEk\9CE-BAR,ElC 1 <br /> ' SU!TOPAL SU!TOTAL s <br /> iFI1MlT S ►EIIMIT f <br /> TOTAl1EE 3 TOTAL FfE f <br /> SIDF VAR�S[T�ACK 5T0.EFT SETOACK R:AN YAftD SEIOACK PLAN CHCCK M1UMIILR PUN CHfCK FfE <br /> (FE RECEIPTNO. <br /> USE ZONE IOTAREA y�[�HTSRE <br /> � ❑YES GNO iF[S VAWATION fEF <br /> 1 TYPE OI CU�57 OCCUPANCY GROUP NO UF DWELIING UNIIS <br /> 9UILUING 3 <br /> SIZE OF 11LOG NO OF STONIES A1A% OCC IOAD <br /> I <br /> PLUM�INC <br /> FINF ZONC UASEMENT HkONOO.NS fIRE SPHINKLERS <br /> REQU�ftED MFCNnNIGL <br /> f7Y[5 ❑NO <br /> i <br /> � AP�ROVALS !Y DATF OTY:H <br /> � 1 ENVIRONMENTAL CMfCK LIST PFNALTY U.9C. <br /> SEC 107�a) <br /> I 7 OUIIDING PLAN$ <br /> J fINE HYOftANi TOTAI <br /> + I FIRE PROTfCTION SYSTEM JEIIMIT YALIDAiION <br /> WHEN PROPERLY VALIOATEDIIN TMI$SPACFI THI515 YOUR PFRMIT <br /> 5 GRADINGIf%CAVATIONBCILARINGILRUONING <br /> 6 OHAINAGF <br /> 7 ENYIRO�MENTALIMPACT51'AiFMENT <br /> B MULTH DISTRICT <br /> APPLICATION ACC OY PLAHS CHfCKED BY APPR f R I SUR,NCE OY <br /> ����� Zl _ <br /> � �J <br /> 91 79 <br />