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„�E,�,,.,, APPLICATION FOR <br />�everett �-ONSTRUCTION °"`�" <br />PERMIT Ei <br />DEPT Of COMMUNITV DEVELOPMENT SERVICES <br />CITY HALL 259�8715 � <br />EVERETT, WA 98201 �COMBINATION ❑ BUILDING ❑MECHANICAL L7PLUMBING PERMIT NO. <br />OWN[R M�II �ODMFSS CITY ZIP PHONF <br />�iCi N�2 J7F �o.Iu 3�f/1 f c"y�2�1 c. �'V6�6Ti 9'd�2 o i 2si -Z�o Z <br />.1RCHITlQ OR DFSICN[R M�IL ADD0.E55 rnv .�. _.._... <br />GFNEN�I CONiR�[ION MAII �pDPE55 CITY 21P PNpNE LICENSF � <br />_ .sq�, f �� �-po � � <br />PWMBINL CONiR�CiOR MAIL �DDRF55 ULY ZIP PHONF �ICENSE I <br />C1�55 Oi '+/OPK <br />EI�NEW ❑ADDITION ❑ALTFRATION ❑REPAIR ❑DEMOLITION ❑FENCE C�SIGN ❑GARAGE ❑BUILDING RELCCATION <br />VeWAT10NOf WORIf <br />t /0 � � � 0 <br />�lSCNItlF WORK <br />�N��q« ���Ev woo> s,—e��- + 1�2���� wqc� <br />PROPOStU USE OI pWIOING <br />Lf Wl DfSCRiVtIOv Uf PROP:NIY �SHOWt� BFIOW ON ettACN fOUR COPIESI <br />l01 BLUO ��O{ <br />eD�Pl55 <br />PLUMBING <br />TYPE OF fIXTURE <br />N'ATFR CLOSET (TOLIFT) <br />AAiMTUB <br />UVATORY �W�SH tlA51N) <br />SMOwEH <br />KITCHEN SINK 6 415P <br />DISWASHER <br />LAUNDRV TRAY <br />WAiEk MFATfR <br />URINAL <br />DNINKINC FOUNTAIN <br />FLOOR OR,\Ih <br />VACUUM HREAKERS <br />ROOf DRAINS—RAINLEADfRS <br />$INK �SFNVICE—P�R, F iC 1 <br />SUBTOTAL <br />►E�MIi S <br />TOTAIfEF S <br />VAR� 5[TI7ACK $TkEET 5CT9ACK RE <br />USE ZONE <br />IYPk Oi C <br />SIZE OF 91 <br />FIRE ZONE <br />l0T AREA <br />NO <br />A►►IIOVAIt <br />7 ENVIRONMENTAL f.NECK lIST <br />7. BUILDINC PLANS <br />] FIRF MYDRANT <br />�. FlqE PhOTECTWN SYSTEM <br />5 CRAOINClkkUVATIONbCLfARINGIGRI <br />6 DkAINAGF <br />7. ENVINONMfNTAL IMPACT STATEMENT <br />B. HFAUY.OISTRICT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <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 BE COMPLIED WITH WHETHER 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 RECULATINC CONSTRUCTION <br />OR TH[ PERFORMANCE OF CONSTRUCTION. <br />� SIGNATUNE OF SONTRACTOR O HO ED A^.ENT DATE <br />YARDSETIIACK � PUN <br />VACANT SITE <br />�YfS ❑NO <br />CROUP NO OF OWFLLING l <br />IES MA% OCC IOAD <br />NIf]NOOMS FlRESPkINKLf0.5 <br />PEQUIRED <br />OYFS ❑NO <br />�Y DATE <br />APPLICA710N ACC. BY P��NS CHECKE� BY I APPR. FOR ISSU�NCE BV <br />9�7-79 <br />TYPE OF <br />REFRIGERATION UNRS—HP. EA <br />BOILERS—M P. EA <br />WS FlRED A.0 UNITS—TONNAGE EA <br />FORCEO AIR $YSTEM$—B.T U. M EA <br />WALL MEATENS—B.TL M <br />UNITMEATERS—BTU M <br />FVAPORATNE COOlERS <br />VEN�IUTION FAN <br />RANGE HOOD <br />AIH HANDLING UNIT— CFM <br />SiOVE <br />METAL FIREPUCf 6 CHIMNFY <br />� •S�t�u� <br />5Uli07AL f <br />►EMMIT f <br />FEE <br />I fEE I RKEIPT NO. <br />fFfS VALUATION FFF <br />BUIIDING f <br />PWN.pING <br />MECHANIUL <br />OTMEH <br />PENALTY U.BI. <br />SEC. N1Ha) <br />TOTAI <br />►ERMIT VALIDATION <br />WHEN PROPERLV VAL'DATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />7 <br />J <br />