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the Evnrpresn /1 ■►— I C A T 1 O N F O R everett <br />°�TM°F CONSTRUCTION e, <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259•8745 <br />EVERETT, WA98201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNEH MAIIAUDNf55 CIiY ZIP PNON[ <br />T�/i// �A/ •Ti /. _ 11.._ . riir..�...v �.. . i. i i� .l._,�.��� �-.s-'7 �^!1 /1� <br />MRC�fR'THR�flSICYM MAII ApDP155 ❑TY ZIP PMONL <br />cgZU 4 <br />G(NfRAI[ONLRAf10R AIAllA0DRE55 ❑IY 21P PHON[ LICENSEI <br />S�G/�/- �-L/%-� i�-D U ��L/ . `S�l�%i� ,LyiVii�� �/8L2j6 '" 2-Z3 -Ol -S1�IS P <br />ie�WR Mell A�pp[55 CIiY LIP P/HONE LICENSE 1 <br />c •}. J, 7 � %�/�Q� <br />�IC��pi�C CONLp�t'tOR mAll �ODRE55 CIiY ZIP PMOHF IICENSE 1 <br />l l �St Uf \10RN <br />�ONEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE �IGN ❑GARAGE ❑BUILDING RELOCATION <br />\1114110.\Of WORK <br />' ��1� 00 <br />n��rxint woac <br />_�(��ci � �G,U�/NTA/.i/ S X� '.C�F /[ L iG�l/,t/.,✓T.�/7 :S'/� ^/ •- /�Qn.JEc i /.�/G <br />rxuvoc�ui�t� or xwmi�+c I HEREBY "ERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />tIG1l DI SCRIPtIOv Of PROP[RIY �SHOKN[ �PLLOW/�OR Aii�n/CH /fO'UJR C�O)P/If�51 <br />llll �2 � fl10fK�OF � /I��✓ hQ� / i%�l /CJ/� <br />TYPE OF FI%TUI <br />' TER ClOSET �TOLIFT) <br />OM UB <br />LAVATO I��'ASM BASIN� <br />SHOWER <br />KITC�IEN SINA d ISP <br />DIS\V�SHER <br />LAUNDRI7HAY <br />Cl07ME51YA5HER <br />tvATER HEATEH <br />URINnI <br />DRINKIhL FOUNTAIN <br />FLOOR DRAIN <br />VACl1UM PRfAKERS <br />ROOF DRAINS-RAINLEADEH! <br />SINK ISFRVICf -HAR ETC � <br />SUB TO <br />PERMIi <br />SIDF YnRfJ <br />USF ZONk <br />TYPE OF C( <br />SIZE OF HL <br />STREFT SCTIIACK <br />l0T AREA <br />� <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />OF WORK WILL 8E COMPLIED W�TH WHE�iriER 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 />SILNATUHE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />MECHANICAI <br />FEE NO. TYPE OF EQUIPMENT FEE <br />A1 _OND UNITS-H P EA <br />REFRI q�TION UNITS-H.P EI. <br />OOLLERS /P EA <br />GAS FIRED A UNIT$-TONNALE EA <br />fORCED Alft 5Y5 M$-B T U M EA <br />\VALL HEATERS-� M <br />UNIiHEATERS-BTU M <br />EVAPORATIVE COOlEftS <br />CLOTlikS DNYfRS <br />VENiILATION FAY <br />RANGFHOOD <br />�IR MANDIING UNIT- CFM. <br />S70VE <br />METAI FIREPUCE 8 CMIMNEY <br />Sl1N TOTAL f <br />VACANT SITE <br />❑YE$ GNO <br />NO OF OWEILING <br />MAX OCC LOAU <br />FIRE ZONE �ASEMENT IIIURUUMS fINI <br />RE� <br />CIYI <br />APVROVALS BY <br />1 ENVIRONM[NTAL CHECK LIST <br />� DUILDING P��NS <br />� RRE MYDRANT <br />4 fIHEPHOTfCTION5Y5TEM <br />5 GRADINU!%CAVq110N6«fARINGGRUNBINL <br />6 ORAINALE <br />7 ENVIHONM[NUIIMPACTSTATEMENT <br />fl MFAliHD6THlC7 <br />DATE <br />PIAN CN[CK NUMBEH <br />FEES <br />�UILDING <br />PLUMIIING <br />MFCNANIUL <br />OTHER <br />PENALTY <br />TOTAL <br />TOTALFEE f <br />PLAN fHECK FEE <br />FEE RECEIPT.Np. <br />VALUATiON FfE <br />s �, QU G <br />UBC • <br />SEC. )03(a� <br />PEN�AIT VAlIDA710N <br />WMEN PROPERLY VALIDATED �1N THIS SPACE� THIS �S YOUR PERMIT <br />�s- !l- ��U 4. 4 (�P <br />�c_U.S ��Z21�/J L <br />