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� <br /> "\ <br /> M�EwryrN^ ApPLICA►TION FOR.-. ���,�„ <br /> ��TM�F .:ONSTRUCTION e <br /> everett PE RM IT <br /> Df:PT. OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259•8745 <br /> EVERETT, WA98201 �COMBINATION ❑ BUILDYNG ❑MI:CHANICAL ❑PLUMBING PEilM1T NO. <br /> OWN[0. Mell�DDNf55 CRY ZIP PMOHf <br /> �/?L'�'tT1��E NEfOLE' 3'305 EV�=Q6/'E�N 1r14y �J7T �/YZc3 3�Fi_�� I5!C1 <br /> AMCHITECTORDLSIGNFR M�IIAUDRF55 ��TY 21V vHONE <br /> .:EN[RAl CO�iN,1QON MAII AODM[55 UiY 21P PHONF UCFn'SE� <br /> sFFP• T—yo <br /> C1F_ ai2Y �vE�r� CU .7'rV: 7�027 G/ '�w� CYNN �.,µ 9f5a3C 77b ��35 St!-./3F�a�rYN�M7 <br /> hRCN�ni[nl CONiRnC10R MnIL AODR65 CI1Y LIP PNO4E IICtH1!� <br /> PWmBI�LCOnTP�CiOR M�II�UDRF55 ❑TY ZIP PHO!�E UCFNSE� <br /> ClASS OF N'ORK <br /> ❑NEW ❑ADDITION ❑ALTERAiION ❑REPAIR I.�DFMOLITION ❑FENCE �II:N ❑GARAGE ❑BU�LDING RELOCATION <br /> WWAiI NOfK'ONK <br /> � �.�Sb a a <br /> oeseemi woeK <br /> rxovosmuse or euuui�e I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEG THIS AP- <br /> CG���s+[=r[S'7¢L ,S,C 6N PLICATION nND KNOW THE SAME TO BE TRUE nND CORRECT ALI. <br /> lEWtpESCPIPiIO�OfPROP[NiY�SHOWNB[lOK'ONet1ACH10UFCOP1l51 PROVISIONSOFLAWSANDORDINANCESGOVERNINCTHISTYPE <br /> OF WORK WILL 8E COMPLIE�WITH WHETHER SPECIFIED HEREIN <br /> ioi eioca_o� OR NOT. TI-IE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> CIVE AUTHORITY TO VIOLATE OR CANC:L THE PROVISIONS OF <br /> ANY OTHER STATE OR IOCHL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> 9GNATURE OF CONTRACTOR GH AUTHOf12ED ACENi DATE <br /> IOfln00R65 <br /> .�3vb �Vrr6RC�•v �,�,a X 1' - - �f-5 - �/ <br /> PIUMB�NG MECHhNICAt <br /> NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSR ROUETI AIR CON� Uh�T$—H P EA <br /> OATHTUB REFRIGEHATION UNITS—MP EA <br /> LAVATONY IH'ASFI 9ASIN� [IORERS—HP EA <br /> $HOWER GASFIHE�AC. UNIT$—TONNAGE EA <br /> KITCMFN SINK 6 OISP FORCED AIR SYSTEMS-0 T U. M EA <br /> �RR'AiH[R N'ALL/IUT[Ri—OS.U. ht � <br /> �� LAUVDNY TRAY UNIT HEATERS—B.T U. Id <br /> �'i CtOTHfS�v�SMER tVAPORATIVE COOLERS �� <br /> \VATER HEATER CLOTH6 DRYFR$ <br /> 11 UHINAL VENTILATION FAN <br /> ORINKINC FOUNTAIN RANGf NOOD <br /> FLOOR DRAIN AIB MANOLING UNIT— C F M <br /> VACUUM OREAKERS 510VE <br /> NOOF DRAINS-0.AINLEADFftS MfTAL FIREPIACE 6 CMIMNEV <br /> ''�� $INK�SFRVICF—BAR,ETC) <br /> � <br /> SUlTOTAL SUE70TAl s <br /> ►FRMIT f ►ERMIT s <br /> TOTAL FEF S TOTAI FEE � <br /> SIDE YARD SCTOACK STRFFT SETBACK R[AR YlNO SLTIIACK PIAN UI[CK M1UMtlER NI�N CHEIX fEE <br /> FEE RECEIPT NO. <br /> USE ZONE lOT AREA VACANT SIiE <br /> �VES ❑NO fFFS VAlUAT1011 f[F <br /> � TYPE OF CONST UCCUPANCY CBOUP NO.OF OWELLING UNITS <br /> HUILDING S�C • ` �7 <br /> SIZE OF tlLDG NO Oi STORIES MA% OCC IOAD <br /> PLI/Ml)ING <br /> FlRE ZONC OASEMENT IIkUflO0A1S REQIJ RfIDNKLFRS MEGIANIGL <br /> �VFS ❑NO <br /> —^ A�PIIOVALS OT DATE OTHFR <br /> 1 ENVIRONMfNTALCH[CKl15T pfNALTY U.00. <br /> SEC.IOJIa) <br /> 1 OUIL�INC PL�NS <br /> J FIRF MYDRANT TOTAL � . <br /> 1 <br /> � FIRE PROTECTION SYSTEht P[RMIT VALIDATION <br /> ' WMEN PROPERIY VAIIDATED(IN THIS SPACE�THI515 YOUR PERMIT <br /> 5 LHADIuQ!%UVAfIONBCIlAHINLIGRU9flING <br /> 6 DRAINAGE C� _ �` p r <br /> 7 fNVIRONMENUL IMPACT STATFMENT S � �y <br /> e MEALTH OISTRICT <br /> �PFLICATION ACC BY RA S CH CKED BY APPR FOR 155�'ANCE BY <br /> 4-( ��8, ti ;u��? <br /> ��'.���/ <br /> %�,�... .�_..�. ��,,.� <br />