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,„,,�,PPLIGATION FO� <br />coNSTRuc�rio <br />everett PE RM I T <br />DEPT. OF COMMUNITY �EVELOPMENT SE3VICES <br />CITY HALL 259�87d5 , <br />EVeRE77,WnnezOt �COMBINATION / <br />�BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OK'NFH AINInF�ONE55 IiIY l.li' i�nune <br />I't r� fi� %g l� 7; o/ 3 3 S CuC�G/�C C R! :✓t� F�=� r1', ?7� � 3a <br />ARUIIIICiONpE51GNlN M1InILAUON[55 CIiY ].IP PHONf <br />everetl <br />e <br />L[N[NAL COrvTHACiOR MML AOURE55 CIIY ].II' PIIONE IICENSE M <br />��/ife � srtlCtl.t/ ,$� e:;i/ c';• •c.l-, ;/"-�t.Ji L. Y�R/. c�../fil p$1�36 '%%6 8835 (7 - J v <br />.ULCNANIULIONiN�CTOR MAIIAUDNEA ❑iY LIP PHON[ IICENSEp <br />PWn1ffINGCONTRACIOR MAIIAU�R65 CIiY 21P PHON[ LICENSFN <br />r❑NEW,oRA❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE �SIGN ❑GARAGE ❑OUILDING RELOCATION <br />� <br />VAIUAil�O7NO`� 1V08K <br />S ! ✓ �� ¢_ <br />D[SCNIOE ��'�RK <br />ERL�c--� s�6�el /d-S r�+� �;n,�Wr.✓6S <br />raoroseouseovnuuowe I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />Cah-�r�-«� l,� L PLICATION �ND KNOW THE SAME TO OE TRUE AND CORRECT ALL <br />LFWLDESCRIPTIONOFPROPENiY�5H0\YNIIELO\YORAiIACHFOUFCOPI[SI PROVISIONSOFLAWS�NDORDINANCESGOVERNINGTHISTYPE <br />OF WORK �VILL (3E COMPLIED WITH WHETHER SPECIFIED HEREIN <br />ior oiocK_av OR NOT. THE GR�NTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANC=L THE PROVISIONS OF <br />ANY OTHER STAT[ OP. LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF l.ONSTRUCTION. <br />�i%� /1 SIGNATURE OF COD�RACTOR OR AUTHORIZED AGFNT DATE <br />� V�=�V�CL'✓�1� W!?_l/ <br />PLUMBING <br />NO. TYPE OF <br />\VATER CLOSET fTOLIE <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISWASHER <br />LAUNDRYTRAV <br />WATPR HEATER <br />URINAI <br />DRI�KING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />SINK (SERVICE-6AR, ETC! <br />PERMIT f <br />TOTAI FEE S <br />;EET S[T�ACK REAR YARD SC <br />LOT AREA <br />OCCUPANCY GROUP <br />FIRE 20`1F <br />APPROVAlS <br />t ENVIRONMENTAL CHEIX LIST <br />2. OUILDING PLANS <br />3. RRE lIYORANT <br />4. FlRE PROTECTION SYSTEM <br />5. GHADINGIE%UVATION 8 CIEARING�GNUB141NG <br />6. DRAINAGE <br />Z ENVIRONMENiAIIMPACTSTATEMENT <br />0. MEALTH DISTRICT <br />API'LICATION ACC. UY LANS HECKF 6Y <br />/ / � <br />� ��✓ <br />JACANT SITE <br />CYES ❑NO <br />NO. OF �WRLING UNITS <br />REQUIRED <br />�❑YES ❑NO� <br />BY I DATE <br />� <br />MECHANICAL � <br />NO. TYPE OF EQUIPMENT <br />AIR COND. UNITS—HP. EA <br />BEFRIGERATION UNITS—H.P. EA <br />OOILERS--HP. F \ <br />GA$ FlRED AC. UNITS—TONNAGE EA <br />FORCED AB 5YA6M5—I1.T.U. h <br />WALL HEATER$—[I.T.U. M <br />UNIT HEATF.ftS—O.T.LL M <br />EVnPORATNECOOL[RS <br />CLOiHES DRYERS <br />V[NTILATION FAY <br />RANGEHOOD <br />AIR HANDLINC UNIT— CF.M. <br />STOVE <br />METAL PBEPLACE R CHIMNEY <br />PLAN CHKK NUMUER <br />FEES <br />UUILDING <br />PLUMIiING <br />MECIIANICAL <br />OTHER <br />PENALTy <br />TOTAL <br />FEE <br />SUB TOTAL � <br />PERMIT f <br />iOTAL FEE f <br />Pi.AN CHECK FEE <br />FFE RECEIPT NO. <br />VALUA710N FEE <br />5 7�, <br />U.I4.C. <br />SEC.703(a) <br />P[RMIT VAUDATION <br />WHFn PROPERU' VALIGATED (IN THIS SPACE) THIS IS VOUR PERMIT <br />�ZU.S �Z_�T. IF <br />'��Z' C� . <br />J <br />Fo �55����� �� �o Pieo��no�.o d� <br />� I Z�3�79 p M�.v�ir/�a seyouo <br />�c�,�Y G��vE - <br />