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I <br />; <br />� <br />A <br />i <br />tA�EwrprN^ A�-�PLICATION FOR ���,�n <br />��TM�F CONSTRUCTION e <br />everett PER�VIIT <br />DEPT, OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259�8745 <br />EVERETT, WA98]Ot �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNFR MAII �OONI55 CIIY ZIP PHONE <br />�fJ/(L✓�$j /�'q��'—L (/030 �Vl�R6R�w% �✓A�Y G�FT <br />ANCIIIifCiORO[SILNIN MAIIADOR155 CI1Y 21P PNONE <br />LINIRAI CONiN�CiOR M�II ��DXL55 CITY ZIP PHONE UCENSf � <br />s�cf7 rf—so <br />/'d �RRY �v��✓ sss,✓ co z.i om� G�'"�' c� c.Y�✓w c%B� 9s�+lc 7�6 srss s.c.� ee�,eRYw sv7ao, <br />n11f1UMUl COYINACiON M1IAII AODNl55 CIiY LIP PNONE IICENSE 1 <br />fll!��Pltif.fONiNRC10F MnIIADDRLSS ❑IY ZIP PMONE IICEN5E1 <br />CI U} UI NORK <br />❑NEN' ❑ADDITION ❑AL'fERATION ❑REPAIR ❑DEMOLITION ❑FENCE �SIGN ❑GARAGE ❑OUILDING RELOCATION <br />\M � IOVOf WOPI( <br />•�-- � <br />❑11CBIN1 1VOR1: <br />o uei oi PUIl01�+G <br />O G <br />llLR �I SCRIP110N OF PpOP[NiY 15110NN 0[LOW ON 41GCN IOUR COPI($1 <br />l01 _ PIGCR � OI <br />IUN ��f1XIS5 <br />/_n <br />PlUM81NG <br />NO. TYYE OF FI)(7URE <br />BATFITUB <br />� UVATORY (WASM OASIN� <br />SHOwF R <br />KITCHfN SINK b DISF� <br />DISWASMFR <br />UUNORY iRAY <br />CLO1Hf5 WASHER <br />WAiER HEATER <br />URINAI � <br />ORiNKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BRFAKfRS <br />ROOF ORAINS—RAINLFAO <br />SIr�KISERVIC!—BAP. FTC) <br />USE ZONE <br />Oi CONST <br />SIZE <br />SUlTOTAL <br />►FIIMIT <br />iOTAI FFE <br />STRFFi SC�flACK <br />LOT AREA <br />OCCUPANCYGROUP <br />NO OF STORIfS <br />BASEMENi HkUHOOMS <br />A►►IIOVALS <br />1 FNVIRONMENTAL CHECK LIST <br />7 BUIL�INC PLANS <br />) FB[ HYDRANT <br />d FIRE PROTECTION SYSTEM <br />5 CRAOINGII%CAVA710NFQFARING/GRUNflING <br />6 �RAINACE <br />7 fNVIRONMFNTALIMPACTSTATFMENT <br />B NFAL7H DISTRICT <br />' <br />�f <br />RUR YAHD 5[TOACK <br />VACANT SITE <br />❑YES GNO <br />NO OF DWELLING UNITS <br />MAX OCC LOAD <br />FIRf SPRINKLCNS <br />REOUIR[D <br />er � DATE <br />u+tcKto uv nr��n ioN istw�c� or <br />! w�rh.�/�ir�c� <br />sa6N wrr�r ,� a x�' Ne�w ,enR e� s,r� <br />1 HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF lAWS AND ORDINANCES GUVERNING THI$ TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTNER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE f'ERFORMANCE OF CONSTRUCTION. <br />SICNATURE �7F CONTRACTOR OR AUTHORIZED ACENT DATE <br />NO. TYPE OF EQUIPMENT <br />AIR COND UNIiS—HP. EA <br />ItEFRIGFRATION UNITS—N P EA <br />BOILER$—H P EA <br />GASRRFDAI UNRS—TONNAGEEA <br />lORCED AIR SYSTEM$—B i U M <br />WALLNEATERS—BTU M <br />U�IiMEnfERS—BTU M <br />EVAPOF.aiIVE COOLERS <br />CLOTIii) ORYERS <br />V[Nl•:ATION FAN <br />Rl.�.GF NOOD <br />A:R HANDIING UNIT— C.F M. <br />$TOVE <br />MFTAL FIREPLACE 6 CHIMNEY <br />PUN CMCCK <br />_�� <br />FEE <br />MIT f <br />AL FEf f <br />PIRN CHECK FEE <br />FEE RECEIPT NO. <br />VALUATION FEF <br />BUIIDING s <br />PLUM6INC <br />MfCHANIUL <br />OTHFR <br />PE NAITY U 6 C <br />SEC 70J1a� <br />iOTAI. <br />�ERMIT VAIIDATION <br />1VMEN PROPERLY VALIDATED pN TNIS SPACEI THIS IS VOUR PfRMIT <br />/o- %80 �e�' <br />�'!Ct N 7b �L� /�L.t.� c��.J <br />