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li <br />r <br />A <br />the Eve�green 9 P P L I C A T 1 O N F O R, everelt <br />°�ry°F CORSTRUCTiOf� � <br />everett PE RM IT <br />DEPT OF COMMUNITV DEVELOPMEI:T SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA9B201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />o�ru[a mnn noux�ss cnr nr v�roN[ <br />�.)h�ie �.�nN� �I� s��� � I taet�r�r �. �..�,� C��et�f 9'�c�3 353-I I�.] <br />ARCHILFCT OR �61CNIR M1IAII �pDN $5 CIiY ZIV PIIONf <br />GEH[PnlCON1NnC10R M1161lAO�FE$5 Cliv 211' PIIONF LIC[NSEI <br />I <br />PIP.NIIWLCOYIXACIOR n1AllA00N65 CIIY ZIP pNONF � IICENSEI <br />CLA55 OI 1VORK <br />ISNE6V ❑ADDITION ❑ALTEHATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VAlUn1104 GI NONB <br />S <br />❑14'NIO[ NOR� <br />US[ OI 11UI101NC <br />ILC�I DISCR�PIION Of PNOPFNIY IS��OKN NfION ON AllAG110Un COPIf51 <br />lOt _ B�OCK _ OI <br />PWMBING (/ <br />NO. TYPE OF FI%TURE <br />F <br />IlATHTUB <br />UVATURY �\YASH IlA51N� <br />SM015'FR <br />KITCHEM1 SINK R OISP <br />DISK'ASHER <br />UUNDRY iNAY <br />CLOTHES wASHER <br />WALER HEATFH <br />UHINnL <br />OHINRWG (OUNiAIN <br />FIOON �RAIl: <br />VACUUM 11R[ AKF RS <br />HOOF �RAINS–RAINLEAOERS <br />SINK ISFRVICI –I{AR. ETC 1 <br />SIpE tAftU flTI1ACK <br />TVPE O� CONSI <br />il(tf <br />SUBTOTAL <br />VENMIT 3 <br />TOiAL FEE S <br />STR[[T SRpnCK Rf <br />LOT ARtA <br />OCNYAN�y GHOUP <br />n0 OF STORIES <br />APPROV�lS <br />1 fNVIRONM[NiAI CHCCK UST <br />7 IiUILDING PLAN$ <br />� riuc �+vounNr <br />4 fIREPNOTLC710N5Y5TEM <br />5 GNA�Wf,�t%UVAilON8CLIAHINGICRUUHING <br />L DNA�NnGF <br />7 ENVIftONMENTAL IMPACT STATEMENT <br />8 MEALTII DISTRICT <br />APPLIUTION ACC BY PUNS CMFIXED BY � APPR FOR ISSUANCE ISY <br />FEE <br />VAUNT 511[ <br />❑1F$ GNO <br />NO OF DWELLING UNITS <br />MAX OCC IOAD <br />FIRE SPNINKLEHS <br />REQUIREO <br />f7Yf5 ❑NO <br />BY DATE <br />9 7 79 <br />I HERE�Y CERTIFY THAT I I1AVE READ AND EXAMINED THIS AP- <br />PLICATION �ND KNOW TI1E SAME TO DE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND OROINANCE$ GOVERNING THIS TYPE <br />OF WORK WILL 6E COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERh11T DOES NO� PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF <br />AVY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />C��R TFJ€ PERFORMANCE Of�ONSTRUCTION. <br />' GNATI�RE OF CONiRACTOR OH HORIZED AGENT DATE <br />NO. —� TYPE OF EQUIPMENT <br />AIH CON� UNIT$–H p EA <br />REFRIGERATION UNITS–H P FA <br />ItOIlERS–HP FA <br />GAS FIRED A C UNITS–IONNAGE EA <br />fORCtO AIR SYSTEMS–(i.T U M <br />\VALI HFA7LHS-67 U h1 <br />UM1�THfAiENS–17TU M <br />fVAPORATIVE COOLEHS <br />RANGFHOOD <br />AINMANOLINCUNIT– CFM <br />n1EUL FlRFPUCE 8 CHIMNEY <br />FFFS <br />SU�TOTAI <br />PERMIT <br />TOTALFEE <br />S <br />S <br />FEE <br />PLAN CMECK FEE <br />F[E RECFIPT NO. <br />VALUATION FEE <br />11UILDING S <br />PWMIIING <br />AIECHANIGL <br />OTHfR <br />PENALIY U11C. <br />SFC. SO)(a� <br />TOTAL <br />PERAIIT VAIIDATION <br />WHEN PROPEPLY VALIDATED (IN THIS SPACEI THIS I$ YOUR PEftM1T <br />6� <br />1 <br />