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APPLICp►TION FO° eve�en <br /> Ine Evergreen C O N ST R U CT I O N e <br /> CITY OF <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br /> ❑TY HALL 259�8745 <br /> EVERETT.\YA98201 �COMBINATION ❑ BUILDING ��11ECHANICAL ❑PLUFABING PERMIT NO. <br /> � OWK[R MAIL�DOM[55 ❑iT ZIP PHONE � <br /> �nin1 �",�„'•CS -ri�� Fi1Ei�v'=��J V�A'� ESJEIZE77� <br /> nRCMI1FCt OR OlSILNFN meR nOURESS ❑iY ZIP FNO�f <br /> GIM1[RnLCOYINACLOR FIULeDDRE55 CIiY ZIP PMON[ IICENSft <br /> MIOUMULCONIR�CTOM MAILAOD0.E55 ❑iY LIV PN04[ —Z77�ICEN$EI <br /> _ .mp,.,/'—_✓�K lhC � Sc�J�c T��� //8�3 iz4T"d,�r- NL Ki�Kc�t�JD � gR��� <br /> Mnn OOX[55 cnr zir vHo r <br /> ri' u�.'wlnc:co�ranaoa � <br /> CU55 Of NOPK <br /> ❑NE�v �ADDITION �IALT;RATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GGANAGE ❑BUILDING RELOCATION <br /> VMU�ilO�Of KOR/R-�/ O O <br /> / �� <br /> t <br /> OISCRIB[�� Rk � • <br /> 2 i � � i i cw U T2� � aeK <br /> rao�se or emimNe I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> CJ PLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT ALL <br /> IEWI U[SCRIP110N Of VROPfRiY�$NO\VN BfIOW ON�1tACH fOUMCOPIF51 PROVISIDNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WIIL 6E COAIPLIED WITH WHETHER$PECIFIED HEREIN <br /> ioi BIOCK�Of OR NOT. THE GRANTING OP A PENMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION$ OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONST��N <br /> OR THE PERFORMANCE OF CONSTRUCTION. � � �? <br /> SILNAiURE OF CONTRACTOR OR UT ORIZED AGENT DATf rJ <br /> ioe eooa[55 <br /> 5�� GuEfz X <br /> PLUMBING MECHANICAL <br /> FEE NO. TYPE OF EQUIPMENT FEE <br /> NO. TYPE OF FI%TURE � <br /> WATER CLOSET(TOIIETI AIR COND UNITS—M P EA <br /> REFRIGERATION UNITS—HP. FA <br /> NATHTUO <br /> LAVATORY(WASN OASIN� 601LER5—H P FA <br /> SMOwER WS FIRFDnC.UNITS—TONNAGE EA <br /> KI7CHEN SINK b OISP FOItCfD AIR SYSTEMS—B T U �.1 EA <br /> WALI HEAi[RS—�T U. M <br /> DIS\vASHER <br /> IAUNDRY7RAV UNITHtATERS—�TU M <br /> ClOTM6 WASMFR EVAI'ORATIVC COOLEAS <br /> WA7FR M[ATfR CIOTMFS DBYEHS <br /> VENTILATION FAN <br /> URINAL <br /> DRINKING FOUNTAIN RANGF HOOD <br /> FIOOR ORAIN AIR HANDLINL UNI7— C F M <br /> VACUUM 6REAKLRS AOVE <br /> ROOF DkAINS—RAINLEADERS METAL FIREPUCE 6 CHIMNEY <br /> SINK ISFRVICE—UAR,ETC 1 <br /> SUB 70TAL 3 6� <br /> SU9TOTAl 3 � <br /> ►EIIMIT 3 PEPMIT <br /> f iOTALFEE S O O <br /> TOTALIEF <br /> pLAN CMECK FEE <br /> SID[ ��RD 5[TUACK STRE(T SCTUACK REAR YARD 5[TOACK PLAN CII[CR NU�10EF FEE RKEIPT NO. <br /> USE ZONE lOi AREA y�[�NT$ITE FEES VALUAiION FEE <br /> OVF$ CNO <br /> TYPE Of CONST OCCUPAnCY GROl1P NO OF �WEIIING UNI75 <br /> nuneir+c s <br /> SIZE Of 11LUC NO OF$TORIES MA% OCi LOAD <br /> PlUMI71NC <br /> FINEZONE OASEMENT BIUNOOMS RtQU1RFDKLERS ��F����NIUL �.Z OO <br /> fIYK ❑NO <br /> APPIIOVAlS BY DATF OfMFR <br /> 7. [NVIRONMENTALCH[CKL15T UOC. <br /> PkNALTY SFC 30J�a) <br /> 2 UUILDING PLANS <br /> TOTAL <br /> 7 FlH[ HY�HANT <br /> � fIRE PROTICTION SYSTEM PERMIT WIIDATION II <br /> \YFIEN PROPENLY VAIIDATED�IN THIS SPACE17HI5 IS YOUR PERMIT <br /> 5 GRADINGIUCAVATIONBQEAHINGILRUHIIWG I <br /> 6 DRAINACE <br /> 7. ENVIRONMENTAL IMPACT SiATEMfNT <br /> B. MEAITN DISTRICT <br /> APPLICATION ACC.BY PUNS CHfCKED BY APPR fOR ISSUANCE BY <br /> 9-1�79 <br /> I <br /> I _ <br />