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APP�.ICATION FO�... ���,�„ <br />�rE�'°"'° :.ONSTRUCTION e <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES . <br />CITY HALL 25i�8745 <br />EVENETT, WA98Z01 �COMBINATION ❑ sUIIDING ❑MECHANICAL ❑PLUMlING PERMIT NO. <br />_ __ ..... .........� nrv IIP PMONE <br />M11fCH�HIUI CONIF�CiOR M�II ADUPFSS CItY !IP PHONf IICEN$E / <br />PWMPWGtONiNACi00. M�IUOORE55 CILY 21P PMONE UCFNSEI <br />CU55Of WORK <br />❑NEW ❑ADDITION �ALTERATIOP' ❑REPAIR ❑DEMOUTION ❑FENCE .�SIGN ❑GARAGE ❑BUILDING RELOGTION <br />VAlU�110N Oi WORC <br />s ��i <br />OlSCRIBF_WOPK _ � n � � _ � (� . n � � <br />IEGAL D6CMIPTION OF PROVERiY �SNOWN 9IlCW OR �iTACH fOUR COPI[51 <br />.or _ eiocK _ ov <br />PLUMlING <br />NO. TY►E OF FIXT <br />WATER ClOSET (TOUFT) <br />BAiHTUB <br />UVAT00.V(W/ BASIN) <br />SHOWER <br />KITCMEN SINK 6 DISP <br />DISWASMER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATER MEATFR <br />URINAI <br />DRINKINC FOUNTAIN <br />FIOOR DRAIN <br />VACUUM BREAKI RS <br />ROOF ORAINS—IfAINlFAO <br />� SINK 6FRVICE-3�R. FTC � <br />USE ZONE <br />TYPE OF CONS <br />SIZE OF BLDG. <br />FIRE ZONE <br />LOT AREA <br />AM�OVAIS <br />1 ENVIRONMENTAL CHECK LIST <br />i. BUILDING PLANS <br />7. FIRf HYDRANT <br />�. FlRE PROTECTION SYSTfM <br />5 LAADINGIE%CAVATION6ClEARINGCRUBflING <br />e oan�Nnc¢ <br />7. ENViRONMENTAL IMPACT STATEMENi <br />E. HEAI.TH DISTRICT <br />APPLIUTION ACC. BY � � CJ�ECKE,D <br />9.1�79 <br />I HEREBY CERTIFY THAT I HAVE RE/ID AND E%AMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF N'ORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE CRANTING OF A PERMIT DOES NOT PRESUME TO <br />CIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNA7URE OF CONTM�CTOR OR AU7HORIZED AGFNT D�E <br />MECMANIUI <br />NO. T�►E OF FQUIfMFNT <br />AIR COND. UNITS—HP. EA <br />REfRIGERATION UNITS—H.P. EA <br />BOILERS—H P. EA <br />GAS FIRFD A.C. UNITS—TONNAGE EA <br />fORCFD AI6 SYSTEMS—B.TL. N <br />W�LL HEATERS�-BS.U. M <br />UNITHEATE0.5—B.TU. M <br />EVAPORAiIVE COOLERS <br />CIOTHFS DRYERS <br />VENTILAiION FAN <br />RANGFMOO� <br />AIR HANOIING UNIT— C.F.M. <br />STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />s <br />RFAR YARD SETBACK PLAN <br />VAGNT $ITE <br />OYES ❑NO <br />NO. OF DWEIIING UNITS <br />�r <br />BY IAPPJI <br />k�j, <br />D <br />DAiE <br />BY <br />TOTAI <br />Ff E <br />fEE <br />• <br />:MECK FEE <br />RECEIPT NO. <br />BUIIDING s'BKY' ` V_ <br />PIUMBING <br />MECHANIUL <br />OiHER <br />PEN�LTV LLB C. <br />SEC. K1Na1 <br />iOTAI <br />�F�M�T �ALiOATION <br />WMEN PROPERLY VALIDATED IIN iM15 SPACEI THIS IS YOUR PERMIi <br />lm- (5--eo �c� <br />/ '+v�-f C��_7/r ( (G��O � <br />