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r InsEveigreen APPLICATI�N FOR . e�e,e„ <br /> ��TM°F �ONSTRUCTION e <br /> everett P�RNSIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259�8745 <br /> E�'ERETT,WA98201 ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWrvLR MAII ADON[$S CII\ ZIP PIIONE <br /> /���� i� /-�e�i 1�t/c /�D �/� � ����ai,-,o i i� � 7ZD/ s 'r���/-575'/ <br /> � ANCHILLCi OP 0[SIGN10. � M�II ADpRF55 ❑fY � 21P PIIONf <br /> /V� - <br /> G[N(pAICONI AQOR MAIlAOp0.6S CIIY ZIP PIIONF LIC[`�SEI I�7O� <br /> a <br /> C/�n/ST,2l�CTiP.r��ON7/2/�GTi�i� /��/D-SS���[ L✓ kn in2iA5 �1ilOL0 7y-'>-Z�ZS Cnbi�* <br /> M([IIANIUI CON^tp LOH MM1IL ADORF55 ❑1Y LIP PMONE lK[NSE 1 <br /> PWMp16CCONIQACiOR M11All�0ONfS5 CIIY zIP PMONI 11�ENSE1 <br /> / <br /> CLA55 Oi KOPK� <br /> ❑NEW ❑ADDITION ALTERATION QREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑�UILDING RELOCATION <br /> VAIVAiION Of 1VONK <br /> + '�� Z � <br /> i <br /> UfSCRi E��'ORA p A <br /> I'��iN0/L �Osnt E—i� /��� O c_— -iv(D✓��clY�L11 '-Sl.'l/ARE l/1/'?C.:C�Q•+L� �n/0. -/i�O�cR.Sd(� <br /> racros�ous�or nundorvc \ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> SAnn �/s �2 IcuS. �= ]i- � .a `, PLIC�TION AND KNOW TH[ SAME TO�E TRUE AND CORRECT ALL <br /> -�� - --...., PROVISIONS OF LAWS AND ORDIP!ANCES GOVERNING THIS TYPE <br /> �, SF1; �1 TWP 2� RGF 0�� �"' OFWORKWILl6ECOMPLIEDWITHWHETHERSPECIFIEDHEREIN <br /> IRT-3°�-"'.A 1 S1/2 f11= FDT Df:G $C- C�R TR A �K NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> PL..1T CF hFST KiDGF TH PJdS#'LO 3CF T�J GNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � �! ST NWY TH NFLY ALG W LN ST ANYOTHERSTATEURLOCALIAN REGULATINGCONSTRUCTION <br /> i I��( 'n' L�' OR THE PERFORMANCE Of CONSTRUCTION. <br /> INL�Y TC Sf- f.C!R LOT ".1 PLA7 OF SCUTH HWY SIGNATURfOfCONTNAQORORAUTHORIZEOAGENT onTe <br /> A�I` TH 1,' AL, S LN LOi 28 TO FLY L�' PLAT � /� " / ?_� <br /> �rF h�� ST Ri�r:: Tli SLY ALG �0 F.�v (.N Tf1 X l �l 'fl E � (�— Z <br /> o��� <br /> . r���.�.�.� . . ... MECHANICAL <br /> NO. TYPE OF FIXTURi FEE NO. 7YPE OF EQUIPMENT FEE <br /> . WAT[RCLOSRfTOLIET� AIHCOND UHITS—HP U <br /> UAIHTUI7 REFRILFNATION UNITS—MP. EA <br /> UVAWNYIIVASH PASIN� OOILfRS-11 P EA <br /> $HO\vE'R GAS FlRED AC UNRS—TONNAGE EA _ <br /> KI ICHFN$INK 8 DISP fORCED AIR SYSTEMi—17 T U M FA <br /> DI$\VASHFR \YALLHEATEN$—OTU M <br /> IAUNONYiNAY UNIiMEATERS—EITU. M <br /> CLOTHES\5'ASM[R [VAPOkA71VE COOLERS <br /> WA7EN MEAiER CLOTHES�HYERS <br /> URIN�L \'ENTILATION FAN <br /> DRINKING FOUNTAIN NANGF HOOD � <br /> fLOON ORAIN AIN MANDLINL UNIT— C F M <br /> VACUUM 11HEAKERS SiUVf <br /> ROOF ORAIHS—RAINLFA�ERS METAL FIRFPUCE 8 CHIMNEY <br /> SINK ISERVICE—f1AN.ETC� <br /> SUB TOTAL SUBTOTAL f <br /> PFRMIT 3 PEPMIT 3 <br /> TOTAL FEE S TOiAI FEF S <br /> SIDE YAftD S[Tf7ACl: STRfLT SCTOACK RCAR YAND SET[IACK PLAN CHCCA NUb10ER PLAN CHfCK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA yqCAN7 SITf <br /> ❑YFS CNO fFES VAIUATION FEE <br /> TYPk OF CONST OCCUPANCV GROUP NO OF DWFIIING UNITS <br /> oUiID�NG 3[, z ��J <br /> sizE oF u�oc r+o or sroaiEs Mnz occ iono n <br /> i <br /> PIUMHING <br /> GIRF ZONE OASEMENT I)1 UHOUn15 FIHk SPNINKLfHS <br /> NEQl11R[U MCCHANIUL <br /> flvl5 ❑NO <br /> APPROVAlS OY OATE OTHfR ' <br /> 1 ENVIRONMENTAL CHECK L15T U.13C. <br /> PENALTY SEC 301�a) <br /> I BUIL�ING PLAN$ <br /> 7 FlHE HYOHANT TOTAL .S'"� �) <br /> d FIRE PROTECTION SYSTEM PEPMIT VALIDAiION <br /> 1YIIEN PHOPERLY VALIDATED(IN TMIS SPACEI THIS IS VOUR PERn11T <br /> 5 GRADINGkXGVATIONbCI.[AHINGIGNUOIIINL <br /> 6 DHAINAG[ <br /> L ] ENVINONM[N7AL Ih1PACT$TATEMENT <br /> 1 HEnLTM DISTRICT <br /> APPIICATION ACC.P`.' PLANS CHECKE�BY APPR. FOR ISSUANCE BY <br /> 9 7�79 <br />