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APPLICATION FOR everett <br />f`�CONSTRUCTION'�` � <br />eve��tt PE f�M IT <br />DEPT. Of COMMUNITY DEVELOPMENT $ERVICES <br />CITY HALL 257�8745 <br />EVERETT, WA9tl201 �COMBINATION C�BUILDING ❑ME�HANICAL ❑PLUM8ING PERMIT NO. <br />Own[n nuunooeczs cm zir riwut <br />.SAN44!/!'/J /''[/L /.VG �.aC/1 `uF2.�n?O�l//.6�i /�d/1^C'!T 3.5'� —/di0 <br />ARCMIi[Ct OR D[SIGh[g � MAII AOOPC55 Cli ZIP PMONE <br />GENCRGL <br />S <br />CONTRACTOR <br />MAII AU�RF55 <br />M11�IL <br />riionE <br />LICENSE X <br />PlUAt81YG CONiRACTON MAIL ADDRE55 ❑TY ZIP Pf10NF LICENSE / <br />CU55 OF \40RR <br />�NEN' ❑A�DITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE �SIGN ❑GARAGE ❑UUILDING RELOCATION <br />VMUATION OL 1400.K <br />' Z�oO� <br />oesea�.n� woa� , „ <br />rnoroseo use or nuuoinc <br />LEWL OESCRIPTION OF PROPfRiY (SIIOWN OELG\V OH ATtA[H FOIIR COPIE5) <br />LOT OLOCK_�OF <br />IOOn�ORESS <br />CIUMBING <br />NO. TYPE OF FlXTURE <br />WATER CLOSET (TOIIETI <br />SHO��ER <br />KITCH[N SINK 8 OISP. <br />DISWASHER <br />LAUNDftYTRAY <br />WATER HEAT[R <br />ORINKING FOUNTA:N <br />FLOOR DRAIN <br />VACWM f)REAKERS <br />ROOF DRAINS—RAINLEADERS <br />SWK (SERVICE—OAR, EiC.� <br />51DE Y�.RD SE7 <br />U=E ZONE <br />TYPE l�F CONS <br />SIZE OF pLUG. <br />1 HERE6Y CERTIFY TH�T I HAVE READ AND EXAMINED THIS AP- <br />PLICATION �ND KNGW THE SAME TO I3E TRUE �ND CORRECT ALL <br />PROVISIONS OF LAW$ �ND ORDINANCES GOVERNING THIS TYP[ <br />OF WORK WILL 6E COMPLI[D WITH WH[THER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIV[ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Of <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE O� CONSTRUCTION. <br />SIGNATURE OJ.20Fj.TRACTO�THORIZkD AG[NT DATE <br />X� <br />MECHANICAL <br />FEE NO. TYPE OF EQUIPMENT <br />AIR COND. UNITS—HP. EA <br />ftEfRIGEN�TION UNITS—H.P. EA _— <br />[70LLER5—N,P. EA <br />GAS FlRED A.C. UNITS—TONNAGE EA <br />FORCED AIR SVSTEMS—tl.T.U. A1 EA <br />N'ALLHEATfRS—�T.U. M <br />IJNIT HEAIERS—�.T.U. ht <br />FVAPORATIVE COOLERS <br />SUB70TAL <br />PENMIT S <br />70TALfEE f <br />STRCET SETOACK RfAft VARD SETI7ACK PLAN <br />LOT AREA <br />OF <br />VAUNT SITE <br />❑YES ❑NO <br />rUP NO.OF DWEL� <br />MAX.00C.LO <br />UROOMS FlRE SPHINKLI <br />APPROVALS <br />L ENVIRONMENIAL CNECK LIST <br />z. ouuoiNc rinHs <br />7. fIRF HYDRANi <br />4. PIHf PROTEC.TION SY57EM <br />5 LkADINCE%CnVATIOYdCL1AHINGIGHU1711WC <br />4. DRAINAf,E <br />Z ENVIRONh1[NTAL IAIPACT STATLW N7 <br />P IlfAlill DISTItI('1 <br />ov <br />VENTILATION FAN <br />RA1:�E Ii00D <br />— CF.M. <br />STOVE <br />METAL FlREPUCF h CHIMNCY <br />nuuoinc <br />1D <br />PLUMOING <br />IRS <br />MECHANICAL <br />DATE OTHER <br />rcrvntrr <br />r� <br />FEE <br />iOTAL s <br />MIT S <br />fAL FEE f <br />PUN CHECK FEE <br />FEE RKEIPT NO. <br />VALUATIDN FI <br />sn�,i„n� <br />u.o c. <br />sec. �o��a� <br />TOTAL I I C <br />PLRMIT VAIIDATION <br />IVHEN PROPERl1' VALI�ATE jI�N �HIS SPA�E) 7HI515 YOUR PERMIT <br />���L9 -C�� �� � <br />����� �'�/, <br />� <br />