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,MEwroM� �`P LI CAT IO N FO R <br />����f CONSTRUCTION <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVEIOPMENT SERVICES . <br />CITY HALL 259�8715 <br />EVERETT,WA9E201 ��OMBINATION ❑lUILDING ❑MECHANICAL ❑PLUMSING PERMITNO. <br />OW R MAII ADOMF55 CITY IIP PNONE <br />���ltl� �'%��vtt��iFcj' c/a/9 ��%ra� ff'vc �'rer�/-- q�'-�u� ,253-/.5/�- <br />�C RFC JR DFSICNFF R M�II �DOR[SS CI1Y 21P PNONE <br />GFNFR�lCUN111�C1011 M�IIAppIlE55 CITY ZIP PHONE UCFNSEI <br />CUSS OF NOPK <br />�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑fENCE ❑SIGN ❑GARAGE ❑BL'ILDING RELOCATION <br />V�WATIOnOf WORN <br />f <br />0[SCNIBE WORK <br />1hs�a// �V''�a s ✓� <br />PPOPOSEO IISF Of BUIlO:YG <br />lE WL UESCNIFTIOn Of FROPFPIY ISHOWN BH OW ON �TT�CN {OUR COVIE51 <br />l01 __ BIOCK ��„ Of <br />10=`�DIl0.[55 � . , <br />�v/ <br />fLUM01NG <br />NO. <br />WA7ER CI <br />BATHTUB <br />f� <br />OF FI%TU�E <br />SHOwER <br />KITCMEN SINK 6 DISP <br />DISWASMFR <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WnTER NEATER <br />UNINAL <br />DRINKINC FOUNiA1N <br />FLOOR DRA�N <br />VACUUM BREAKENS <br />ROOF DNAINS—RAINLFADER! <br />SINK �SERVICE—BAR. ETC' <br />SU� TO <br />f[�MIT <br />TO1Al <br />SIOF YARD SETBACK STREFT SE <br />USE ZONF LOT AREA <br />TYPE OF CON57 OCCUPANI <br />SIZE OF BIDG. NO. OF ST <br />RRE 20Nc BASEMENI <br />APMOYAIf <br />1 ENVIRONMENTAICMFCKLIST <br />2. BUILDING PLAN$ <br />7 FIRE HVDRANT <br />/. FIRE P0.0TECTION TYSTEM <br />5 GRAOINGEI(CAVATIONBCIEARINGGRUBflINC <br />6. DRAINAGE <br />7. ENVIFONMENTAL IMP�CT STAiEMENt <br />!. HFAITM PISTRICT <br />�� <br />S� � <br />REA0. YARD SETBACK <br />VACANT $ITE <br />❑VES ❑NO <br />VO.OF DWELUNC UNITS <br />MA%.00C LOAU <br />FIRE SPRINKlERS <br />REQUI0.ED <br />�YES ❑NO <br />�V UAiE <br />AFPIICATION ACC. BY PUNS CHECKED BY � APPR. fOR ISSUANCE BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINiD THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORFFCT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS iYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HER:IN <br />OR NOT. THE GRANTINC 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 />SIGNAIURE OF CONTRACiOR OR AUiHORIIED AGFNT DATE <br />Y �.lLK C �fF-��...a0.�i�,-, i-QM.i�1 , 8/ <br />REfRIGERATION UNITS—H.F. EA <br />BOILERS—H P. EA <br />CAS FIRED A.C. UNITS—TONNALE EA <br />iORCFD A�R SYSTEMS—B.T.U. M <br />WALI HFATFRS—B.T.U. M <br />UNITMEATERS—BT.U. M <br />FVAPORATIVE COOLERS <br />CLOtMES DRYERS <br />VFNTILATION FAN <br />RANGEHOOD <br />AIR NANDLINC UNIT— CF.M. <br />STOVE <br />MFTAI FIREPLACE 6 CNIMNFY <br />�ElMIT <br />PLAN CHFCK FEE <br />FEE I MECFIPT NO. <br />BUILDING s <br />PLUMBING <br />MECMANICAL <br />OTHF0. <br />PENALTY U.B.C. <br />SFC. JON�) <br />TOiAI <br />►EIIMIT VALIDAiION <br />WHfN PROPERLY VALIDATE� (IN THIS SPACE) THIT IS YOU0. VERMIT <br />� <br />