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� ApPLICATION FOR ���nn <br /> fMEruprMn �p N ST R U CT 1 O N � <br /> cm oF <br /> everett PERMIT <br /> DEP7. OF COMMUNITY DEVELOPMENT SERVICES . <br /> CITY HALL 259�8715 <br /> � FVERETT,WA98201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMlING PERMIT NO. <br /> � IMIt e N65 CITY 21P PXOMF <br /> ' � �l' �oX a��� �vNr�7f L�iJ� ��5.�--���� <br /> 5 u � � i L <br /> ARCNIT[CT OR OISIGNI0. <br /> M��L��U0.65 CIT1 ZIP PHONE <br /> GEN[qAI�ONiR�CTOR M�II�OD0.E55 CITY ZIY PH�JNE IICtYSF/ <br /> S �'� <br /> ME(H�vIUI OiyiTR�CiOfl MAIL AO�PE55 CIIY tIP PHOHF IICENS!� <br /> !1 g�yc� K <br /> Ju �� <br /> PIUMpI�G CONTReQOR M�II e00Rf55 ❑TY ZIP PMOHE IICENS[I <br /> - CUSS Of N'ORK <br /> ❑NEW ❑ADDITION .�LTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDINC RELOCATION <br /> vnweriorv or woaK <br /> t <br /> Ot5[PiP(WOyRK�l' ��JyJ(//� ^ �/n� — <br /> �J.�: VL � ' � W �w� . WL✓` � . � . � <br /> PPOPOSEDUSFOf BUIl01NL I HEREBY RTIfY THAT I HAVE READ AND EXAMI D THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> IEWL DFSCPIPIION Of PROPLNIY ISNOWN B[lOW OR reo+ro corrtsi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THI$TYPE <br /> ., OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ior.�o�oca_or � OR NOT. THE CRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOGL LAW REGULATING CONSTRUCTION <br /> � OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONTRACTOR OR AUTHONIZED AGFNT DATE <br /> IOP�P[55� �_L�.` �� 1 A f!J Il/ � V( <br /> 7 W <br /> FLUMBING MFCHANICAL <br /> NO. TY�E OF FI%TURF FEE NO. TYPE OF EQUIfMENT FEE <br /> � WATER ClOSET�TOLIETI AIR COND UNIiS-H P.EA <br /> BATH7UB NEFRIGERAiION UNITS-H.P.EA <br /> UVATORY�WASM 9ASIN� BORERS-HP. EA <br /> ' SHOWFR G�5 FIHED A.C.UNIiS-TONN�GE EA <br /> KITCMEN SINK 8 DISP FORCEO AIR SYSTEMS-B.T U. M EA 6 <br /> DISWASHEN wALL HEATERS-B T.0 M <br /> LAUNDRY TRAY UNIi HEAIERS-B T U. M <br /> CIOTHES WASHCR EVAPONATIVE COOLERS <br /> ' WATER MEA7ER CLOfHES DRYERS <br /> URINAL VENTIUTION FAN <br /> UHINKINGFOU'�`1TAIN NANLE HOOD <br /> FLOOR DRAIN Alft MANDIING VNIT- C F M. <br /> VACUUM BREAK[RS STOVE <br /> ROOF DFAINS-RAINLEADERS MfTAI fIFEPLACE 8 CHIMNEY <br /> SINK ISERVICf-BAR.ETC 1 <br /> SUlTOiAI SUl70TAL f <br /> tERM1T f �ERMIi � <br /> iOTALF[E f 70TALFEF � <br /> SIDE YARD SCTOACK SiREET SCTOACK RU0.YARD SEIOACK PUN CHECK NUMBER pP AN CHfCK fEE <br /> �/ /J��� FFE � 0� RECE�NP./ <br /> � .7 f� <br /> � USE ZONE lOT AREA yACANT SRE FFES VAL'JAiION f[E <br /> �VES ❑NO <br /> iYPE OF CONST OC JPANCY GROUP NO Oi DWfLLING UNITS �� <br /> �"'.. � f{R R�J�1oDE1 Pj'1 BUIIDINL f���.`�Z'" �jC� _ <br /> 512E Of I1L�G NO OF STORIC$ MA% OCC IOAD <br /> � I —� PWMBING <br /> FIRF ZONE BASEMENT 17FUHUOh15 FIRE SPRINKLfRS 6 <br /> REQUIHEp� MCCHANIUL a <br /> —^ ❑YFS [?RO <br /> ��f�OVAlS /Y �ATE OTMER <br /> 1 ENVIRONMENTAL CHECK LIiT PENALTY U.B C. <br /> SEC.lO](a) <br /> 7 BUILDING PlANS <br /> TOTAI <br /> l FI0.E MY�RANT <br /> 1 FIRE Pp07FCTION SYSTEM tFI1MIT VAIIDATION <br /> - WfiEN PROPERLY VALIDATED(IN THIS SPACEI TMIS IS YOUR FERMIT <br /> 5 GRAOiNGILECAVATION8QEA0.1NpLRUtlPINC <br /> 6 D0.AINACF <br /> L ENVINONMFNTALIMPACTSTAT[MENT <br /> E. HfALTN DISTRICT <br /> APVLICATION ACC.BY PlANS CMEIXED BY APPR.FOR ISSUANCE 9Y <br /> N-urm �--- - �-- � <br /> 9.1�79 <br />