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fhe Evergreen .� P P L I� A T I O N F O R. <br />CITYOF .�OP�JSTRUCTI�ON <br />everett PERMIT <br />DEPT OF COMntUNITY DEV[LOPMENT $ERVICES <br />CITY HALL 259-0745 <br />EVERETT, WA9B201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />� awNtx .tiuu nooerss cnr z�p r�wn[ <br />' CL��-���,� 6 �3 i � ��... �.M, f�..�xr <br />ANOIRICL OR U(SICNIX AIAII AOONE55 CIiY jIP PIIONE <br />everett <br />� <br />. G[N ICONINnCtOM ,/� bUllnpC�.:.f55 SIiV ZII' PHONF LfF�NS/10-n�n <br />��r„�-d,...�s G��, ��,;..y {?o, f3ex S7l ���.�a 9�goz� �?S 3 iy l Z°Za�t�'� <br />.VtC1UNIUl COMNACION .NAII AOpNFSS UIY 21P Pf10Nf IICEN$F � <br />I4V��I1itiG [OrvINnCiOR b1All nODRfSS CIIY 21P PHONE UCENSF Y <br />❑NEW ❑ADDITION ❑ALTERATION <br />V�WnllOu Of wORR <br />, yo �..�, �.e <br />DtSCXilll �tOkrt <br />%.�. ,,�,� r,�� - 2.� <br />��k����5� � � >, �„ N����� ;, � <br />ftEPAIR ❑DEMOLITION ❑FENCE ❑SICN ❑GARAGE ❑BUILDING RELOCATION <br />ltcnL Olscu�r'nov or vNOPtxiv�sMONT ntlOR' Ox nrrncll rOUN cor115) <br />lUl li101n � Oi <br />1011 AU[]N! SS <br />� v��� <br />PLUMBING <br />NO. <br />F <br />TYPE OF FI%TURE <br />IIATHIUB <br />LAVATORY p4A5H dA51N� <br />SHOwlR <br />I:I7CHEN SINK 8 DISP <br />06tvn5Mte <br />UUNDRY 7NAY <br />CLOtHLS�v�SHEN <br />N'qiEN HfATfR � <br />URInAI <br />nNINNINC fOUYT�IN <br />FLOOH pHAIN <br />VACUUM HHEAAfRS <br />ROOf pRAINS-ftAINLkADkHS <br />SINK ISFN\9CE-IlAR ETC ) <br />USF ZONE <br />OF COM1'Si <br />ZONL <br />SUB TOTAL <br />PERMIT <br />iOTALfEE <br />STREET SET[IACK <br />LOT AREA <br />OCCUPAhCV GRC <br />NO OF STORIES <br />�ASEMENT 171 <br />APPNOVALS <br />1 ENVIHONMENTAL CHECK LIST <br />z uuuurvc rtnNs <br />3 FIH[ HIUNAN7 <br />i RNE PHO7fCTION SYSTEM <br />5 GNA�If:CrfxCAVATION6QfARINCICRUNfIING <br />6 �NAINAGE <br />7 ENVINONMENTAIIMPACTS�ATEMENT <br />8 HUITl1 DISTNICT <br />FEE <br />s� � <br />RUH YARD SETpACK <br />\'AUNi SITE <br />❑YFS ❑NO <br />NO OF �WELUNG UNIIS <br />MA% OCC LOAD <br />BY I DATE <br />APPLICATION ACC OY PLANS CHECKED �Y � APPR. FOR ISSUANCE UY <br />9! i9 <br />I HEREBY CERTIFY TH�T I HAVE READ AND EXAMINED THIS AP- <br />PLICATION �ND KNON�' THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 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 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SICVATURE OF CONTNACTOR OR AUTHORIZED AGENT DATE <br />x ,%,� 5�D /0����2 <br />NO. TYPE OF EQUIPMENT <br />AIN COND UNITS-H P [A <br />REF�2IGERATION UNITS-H 1' EA <br />ROR[RS-HP EA <br />CAS I IRED AC UNITS-TONNALE EA <br />fONCEUTIN5Y5TEM5-dTU �! <br />\VALIHtAitNS-l1iU M <br />UNIT HFATkRS-0 T U M <br />EVAPONAiIVE COOLERS <br />C1.07HF5 �RYERS <br />V[NiILATIOK FAN <br />HANCEHOJD <br />AIR HANULItiG UNIi- C F M <br />SiOVE <br />MFTAL RHFPLACE 8 CHIh1NEY <br />fEES <br />TOTAI s <br />MIT S <br />Ul iEE 3 <br />PLAN CMEIX GEE <br />FEF ftKEIPT NO. <br />VAWATION FEE <br />EIUII.DINL f <br />PWMt11NC <br />MECHANIUL <br />OTHEft <br />PENALTY U.9S. <br />SEC 3071�1 <br />TOTAL <br />PFRMIi VALIDATION <br />WHEN PROPERLV VALIDATEO (IN THIS SPACE) 7MI5 IS YOUR PERMIT <br />�� <br />