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�:�PPLiCATION FO� <br />' CONS�Ri1CTiOh <br />everett PE RI� I T <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALI. 25n-g7q5 <br />EVER[TT, WA98201 nCOMBINATION ,� BUILDING CIMECHANICAL ❑PLUMBING PERMIT NO. <br />everetl <br />e <br />/� G 33.�r c'�/ER 6 B�.' L U7% �O 3 O <br />AHCP.1 EfTOR�E51LNtR h1AllA�ORfSS ❑iY ZIP PHONE <br />GFkf0.ALCONiNACTOR MAIIADDRf55 UiY ZIP PIIONE �lIC�S�N <br />R�'2Y Neo,✓ sl�sni �a z�ai� �is'`�✓ �YNN �s'e�s� 776 Ss3a r��R�N��� <br />MEUUNIUL COUTR�CiOH Atnll AUDR65 UiY J.IP PIIONF IICENSE N <br />PLUS1111RG CONTRAROR MAIL AODRE55 CIiV ZIP PIIONE LICENSE p <br />❑NEW ❑ADDITION ❑ALTERATIO� ❑REPAIR <br />VALUATION OF N'ORK <br />s Q'O �da <br />uEs me �eoa� <br />�'/��G�" /J^ woap�N <br />reorosm usr or umioir+c . <br />�orY+ �r�R c.��9-� <br />l( WL DESCHIPTION O( PHOP[RIY �SHO\VN �EIOIY OR ATi�CH FOUR COPIE51 <br />lOT 11LOC1:_Of . <br />rT c/c" <br />IOP ADDRE55 <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />WATER CLOSET ITOLIF.T) <br />SHOWEN <br />KITfHEN SINK & DISP. <br />DISV'ASi1FR <br />LAUNDF�Y TR/.Y <br />CLOiHES\VASHER <br />WATER HEATER <br />UNINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VnCUUA1BREAKERS <br />ROOF DRAINS—RAINLFADEkS <br />SINK 6ERVICE—�AR, ETC.) <br />SIDE YARD SFTI3ACK <br />USE ZONE <br />TYPE OF CONST. <br />SIZE OF �LDG. <br />FBE ZON[ <br />(?l...=/� <br />TOTAL FEE <br />STRECT $ETI3ACK <br />LOT AREA <br />OCCUPANCV GROUP <br />NO.OF STORIES <br />IlASEM[NT OfUHO0A8 <br />APPROVALS <br />L ENVIRONMENTAL CH[CK LIST <br />2. OUILOING PLAN$ <br />1 FlftE HYDRnNT <br />4 FlRE PHOTECiION SYSTCM <br />5 GRADINC�f%CAVATIONBCLFARWG/CRUI1111NG <br />b DRAINAGC <br />7.ENVIRONMENTALIMI'ACTSIATEMENT <br />tt HEAITH DISTRICT <br />f <br />❑DEMOLITION ❑FENCE �SICN ❑GARAGE ❑6UILDING RELOCATION <br />s7"Jicic�v�?E �gs PG�'R /7R/�'�l..�v <br />I HEREE3Y CERTIFY' THAT I HAVE READ AND EXAMINf.D THIS �P- <br />PLICATION AND KtJOW THE SAiviE TO 8E TRUE nNG CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL 6E COMPLIED WITH WHETHER SPECIFII:D HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PP.ESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCFL THE PRO'✓ISIONS Of <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNA7URE O CONTNACTOR OR AUTHORIZEU AGENT OATE <br />X i4� G<� J2—Z$=�`� <br />FEE NO. TVPE OF EQUIPMENT <br />AIR CO`1D. UNITS—H.P. EA <br />REFRIGEftnTION UNITS—H.P. EA <br />IIOILFRS—HP. E4 <br />GAS FlRED A.0 UNITS—TONNAGE EA <br />FORCED NR $VSTEMS—�.T.U. M EA <br />\VALL HEATEkS—U.1L. M <br />UNR IIFATCRS—RT.U. M <br />CVAPONATNk COOLERS <br />CLOTH[5 URYERS <br />VFNTIlAT10N FAN <br />RANCPHOOD <br />AIR HANOLING UNIT— Cf.ht. <br />STOVE <br />METAL PIREPLACE R CHIMNEY <br />SEiOACK � PLAN <br />VACANT SITE <br />❑Y[5 ❑NO <br />NO. OP DWFLLING UNI <br />MA%. OCC LOAD <br />FIRE $PNINKL[HS <br />REQUIRED <br />❑YES ❑NO <br />BY DAiE <br />SUB TOTAL s <br />PERMIT f <br />TOTALFEE S <br />FEE <br />NUM1111ER PLAN CHEIX FEE <br />FEE RECEIPTNO. <br />FEE� VALUAiION FEE <br />DUIL�INC 3 <br />PLUhiRING <br />A1KhIANIGL <br />OTHER <br />PENALTY U.(i.C. <br />SEC.IOIIa) <br />TOTAL <br />PENMIT VALIDATION <br />WHLN PBOPCRLY VALI�AiED (IN THIS SPACE) THIS IS YOUft PERMIT <br />�t� N C �`:_•.; �ni /�l--<} r- I : <br />