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,„.EW,o�.� AP.PLICATION FOR _ <br />"'"°F (.JNSTRUCTIO�N <br />everett PERMIT <br />DlPT. OF COMMUNITY DEVELOPMENT $ERVICES <br />CITY HALI 259�8745 � <br />EVERETT, WA9B301 ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑pLUM61�G PERMIl' NO. <br />OWNIR/' / MAll�00M[55 �ITY 21P PMONE <br />� W <br />everen <br />e <br />_• AS�i�%B 1'�lhcBc�? f� 332 � Al�n/o.2 �/� 9£'s'Zo � Z S�/ s�9 <br />ARCNIIFCT ON DESIGN[R MAIIADDRF55 CITY ZIP PMOHE <br />GINFNM[pNJNACIOR MAIL�pONESS CITY ZIP PNONE ll[ENSEI <br />....-.......��......�„n��v. mnnnuuxoa CIIY IIP PHONE� IICENS[! <br />PLUMPIhG CONtRACiOR MAIL �OOPESS �IiY ZIP pHONE IICENS[ I <br />CL�55 Of N'ORK � <br />❑I:EW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCAIION <br />VAWAtION Oi WORR <br />� � <br />3 0 <br />D[SCRIBF WORN � <br />YR01'OS[U Uif Of BUILDING <br />IFL�I OFSCRiP110N Of FpOPERTY �SHOWN Bf lOW OR �TLACM fOUR CO`PIE151 <br />l01_�BIOCK�Of ����L� ���{i(�NS <br />L <br />IOP �OOR[55 <br />PLUMBING <br />NO. 'YPE OF <br />WA1ER ClOSET (TOIIE <br />OATHTUB <br />IAVATORYIWASH BA� <br />SHOWER <br />KIICHEN SINK 8 DISP <br />DISWASMER <br />IAUNORVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />DRINKING fOUNTAIN <br />FIOOR DRAIN <br />ROOi DRAINS—RAI <br />�EIIMIT f <br />TOiALFEE f <br />SIDF YARD SITBACK STREET SCTBACK RCAR <br />USE ZONF LOT AHEA ����� <br />❑YES <br />TYPE OFCONST. OCCUPANCY LROUP NO.O <br />ov a�oc <br />BASEMFNT � f1k�ROOMS <br />s <br />Af►ROVAlS <br />1. ENVIRONMENiAL CHECK L�ST <br />2. BL^LDINL PUNS <br />J FIRE MYORANT <br />I FIRE PROTECTION SYSTEM <br />5 GRADINGIlXCAVATIONdQFARINGlLRUBflINC <br />6 DRAINACE <br />7.FNVIRONMENTALiMPACTSiATEMENT <br />6 HfAUH DISTNIR <br />I HEREBY CERTIFY THAT I HAVE READ 4ND EXAMINcD THIS AP- <br />PLICA�IO� AND KNOW THE SAME TO P. I RUt AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF �YORK WILL BE COMPLIED WITH WHE7HEF SPECIFIED HEREIN <br />OR NOT. THE CRANTINC OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW RECULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUHE (�.�^ONTRACTOR OR AUIHONIZE� ALENT DATE <br />MECHANIGL " '� <br />FEE NO. TYPE OF EQUIP�IENT <br />AIR COND UNIiS—H.P. EA <br />REFRICERATION UNITS—H P. EA <br />OOILEHS—M P. EA <br />CAS FIRED A C UNITS—TONNAGE EA <br />FORCEDAIRSYSTEMS—BSL. M <br />WALLMEATERS—BT.U. M <br />UhITHEATERS—BTU. M <br />EVAPORATIVE COOlERS <br />CIOTMFS ORYERS <br />VENiILAiION FAN <br />RANGfMOOD <br />AIR MANDIING UNIi— �.FA <br />ST�VE <br />METAL FIHEPUCE 6 CHIMNEV <br />DACK PLAN CHECK NVMBER <br />fFES <br />�G UNITS <br />� <br />n+nx oa wno <br />�Y � DATE <br />SU! 70TAL 3 <br />►FRMIT f <br />70TAt FFF f <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />VAIUATION il <br />Ol11LDING S�. " /U <br />[ <br />PWMOING <br />MFCHANIGL <br />OTHER <br />PENALTY U.B.C. <br />SEC. 30J(e) <br />iOTAI l O <br />L <br />►EIIAIIT VAI�bAiION <br />WMI N PROPERLV VALIDAiED (IN THIS SPACEI TMIS IS YOUR PERMIT <br />