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., . „ �PLICATION FO� evereM <br /> everett � PERMITTi�N � <br /> DEPT. OF COMMUNITY �E�FLOPMENT SERV�CES <br /> CI7Y HALL 259-8745 ,�/ <br /> EVERETT,WA 98201 �COM8INATION ❑ BUILDING ❑MECHANICAL 'Ll' PLUMBING PERMIT NO. <br /> �JN�HEN MAII.A��N�/�� �/���0/Q G./���C� 7!/� 4 PII�7(7 � ���� V <br /> L�"���9Fc � , Goerz <br /> �RCHII[RORUESIGNFN ,V�II�ODNE55 � U1Y ZIP PIIOrvE <br /> LFN[NM.[CN�VACIG2 MAII ADDN65 flll' ZII' PHOM1E IICENSE M <br /> MECMANIUI COAt4n•:iJ6 M�IL AppHF55 ❑iY 21P PHON! UC[NSE N <br /> PWM1IPINGCONiNACiON AUIlAU0H65 ❑IY LIP PHON�y,IO LICFNSft <br /> _/�A-U� �PA.✓�S �uels �s9-�f� <br /> CU55 Of N'OMN <br /> ❑NEW L��ADDIiION ❑AlT[RATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> wwnnnN o�wowK O <br /> S (�O � <br /> 0[$CNIUf\VO��RK <br /> L�DOf.bF�Owl .n��.�/BA/P!� .Si.VL"V �Bi t Pn/C'�1'E e AvAi�t v�pao/L <br /> vaorosroust nr nwtoin�c I HEREf3Y CERTIfY THAT AVE RE�D AND EXP`AINED THIS AP- <br /> PLIC�TION P.ND KNOW THC SAME !O �E?RUE AND CORRECT ALL <br /> iEen�oescxirnon or reoreatv ivwwN onowo��irnoi r �a corns7 PROVISIONS OF I.A\NS �ND ORDINANCES GOVERNING THIS TYPE <br /> n OF WORK WILL 6E COMPLIED WITH WHFTHER SPECIFIED HEREIN <br /> ior �� nioc��L..or Q�UCd/�� �L l� OR NOT. THE GRANTING C�F A PERMIT DOES NOT PRESUME TO <br /> /' � / t / � � / GIVE �UTHORITY TO VIOLATE OR CANCEL THE PROVISIOIJS OF <br /> ,h�£ G.t7Sr �a� OQ" /OToZS�,4x10 NB.'I➢ o.� qNY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> / / Q / y OR THE PERFORMANCE OF CO�STRUCTION. <br /> (Ar r��� ¢J<OC 0. 7 _ _ N �-��� SIGNATURf Oh iONTNnCTOR OH AUTIIORIZED ACENT DATE <br /> �o�,��»R�55 .�� ����� `l,� 79 <br /> .�a�.c� - yll �,e,✓a .�[�r-r- � <br /> PWMBING MECHAIJICAL C/ <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EQUIPMENT FEE <br /> ✓ 1VAiFR CLOSCi(TOLICT� �IR CONU UUItS—H�' EA <br /> ftATHTUfI g[fRl(;FHAiION UNT: -H.P FA <br /> ✓ IAVATORVpVASH1IASINI �':1�R5—HP fA <br /> � $HON'fH G,15 fBFD A.C. UNITS—TONNAG[ FA <br /> KI7CHFN SINK k DISP- I OFCLD AIR S`.'SI6N5-11 T U M EA <br /> UISWASHFR U'Al.l H[ATCRS-11.TL. M <br /> I.AUNDRYTkAI' UNI7111nICNS—ItiU M <br /> CLOTHES�VASHEH FV.APORAiIA'f COOLEHS <br /> \VA7CH HFA:ER CLO1HfSf)RYfRS <br /> UNINAL VEn7ILATION PnN <br /> �NINI;IM1C fOUNTAIN HnNGfI HOO� <br /> fLOOR DRAIh ��N IIANDLItiG UNIi— C F.N. <br /> VACUVA111RUKfRS Si0\'1 <br /> ROOF URAINS—NAINLFADfHS hllJAl. I IHkPLAC[ F CIIIh1NEY <br /> 9NK(SfRVICI:—linN,fTCJ <br /> SUB TOTAL SVB TOTAI f <br /> P[RMIT S PENMIT S <br /> TOTAL iE[ S TOTAL FEE S <br /> SIDf. YARn SETIIACK STRkCT SC7114CK HfAN 1'AND SITI7TCK PLAN CHFCK NUAtI{[H PLAN CH[CK PCE <br /> f(k RECCIPT NO. <br /> USL lONf IAi ARFA vAG\NT'�Ill: <br /> iiYFS ❑::O FfES VALUATION FEE <br /> TYPE Of CON51. OCCUPANCV GNOUI' u0.Of U�YfLI ING UNI75 <br /> 11UIIDING b <br /> SIZF OF ULUC. NO OF SIOHIES htA%.OCC LOAD <br /> PWh1111NG <br /> �IRE ZONC 11ASEMCN7 111 OROf)��N IIRI 51'NINCILBS <br /> HIQUIRLD AILCHANIUI. <br /> 1 I IVIS f I�O <br /> __ APPPOVAlS BY DATE p111CR <br /> i. ENVINONMLN�AI.CHCCKLIST <br /> VCNALTY U I7C. <br /> 2. f1UII.DINC PLANS SCC. 30J�a) — <br /> 3. FIHI. HYDHANT T�TA� <br /> Y RHE PROi[CTION SYSTF'M p[RMIi VALIDATIDN <br /> 5 GR?UWGif:%CAA'AIION S Cl l ARiNGfCHUI?IflAG �����h�'kOP(Rl.l'V'nl IOA71:D IIN 7HI5 SPACf)THIS IS VOUH PEHMIT <br /> 6. ORAINAGL <br /> Z FNVIRON�AtEMTAL IIdPACI STATEMCNT <br /> 8 HFnLTH UISTHICi <br /> APPI.ICATIOh ACC. 0Y PLAN$CHlIXEI)OV APPN ION ISSUA4C1� IIY <br /> 9-1-79 <br />