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r <br /> fAeEverD�� � APPLICATION FOR� ���,�„ <br /> "TM°F . � :ONSTRUCTION <br /> everett PERMIT e <br /> DEPT. OF COMMUNITY DEVELOPMENT $ERVICES <br /> CITV HALL 259�8745 <br /> EVERETT,WA 98I01 �COMBINATION � BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> O\YNIR ���Il AOLlMISS ��{y ZIP eryON[ <br /> � i��tii�,,.J a 3 v�7, .u,C�:1 �-�c� 1,�.i a i — <br /> ARCIIIYIROftDF51CN!/ M1IAII.�UOXl55 CIIY ZIP PHONE <br /> D� � CT1 <br /> Gfn�q)t COVIA�CiOR I�It A�DRlSS /� �ilv ZIP PMONE IICFnS[� <br /> NQ--y��e�.-P,� ��—.,:4.c,.��k.,.. . �'1=�� YJ' L'-,•e�c_c�Lf' !/�%'-o-'� .3�?-yi121 a3�f�D� <br /> 4�It11A�viUl COrvtdlQOq // nlMl nD�REST CrtY ❑1' pryOrvF �IC[NSE 1 <br /> U <br /> PI V1101\G CONiXAQOR M�II A�DN65 ❑tY IIP pNONF �IC[NS[1 <br /> CUSS Of NORK <br /> ❑NE\V ❑ADDITION ❑ALTERATION �REPAIR ❑DEAtOLiTION ❑FENCE ❑$IGN ❑GARAGE ❑BUILDING RELOCATION <br /> I�AlU�110401\YOPK=C <br /> � 3soo ° <br /> U�.MJtIPf NORA _ / � � � yq� L��L�L�-r kJ � f���� <br /> (/l. .�. :6�—�� /.l-c-i'-.'.�'r � +-.J '`) <br /> e J m.L..0 �:L-�-a�C,d ow .G�' ,w. <'.�/�.:z.�-a� l�tc.,� <br /> ruo�ds�ous�oi nm1i�i. � I HEi.CBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> ,�LC.1 c.cC.-c�_-c-� '^ATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> llCAl�I'CRIPiION Of PPOPl0.LY�SN0�5H gUo�v qN Ali�(H 10 x corusi rROVI510N5 OF UWS AND ORDINANCES COVERNING THI$TYPE <br /> ,}.C�j� y �tJ yu�„� ��1 �(1 OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> �.oi _ewcK_o� OR NOT. THF GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATINC CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGYATURF Of CON7RACTOR OH AUTHORIZED AGENT OATE <br /> ion nooatss� �O 7 �2.�`. � 9+,/J,{JG S-.Y,7 'dy �_ <br /> X � ' / <br /> i; <br /> PIUMBING MECHANICAI � <br /> NO. TYPE OF FI%TUNE FEE NO. TYPE OF EQUIPMENT FEF <br /> \VATFR CIOSET�TOIIfT� q�H COND UURS-H P U <br /> 17AT11TU6 REFRIG[RATIONUNITS-HP EA <br /> LA\'ATORY(WASNOASIN� pOILlRS-NP U <br /> SHOWfR GASRRFDAC UNITS-TONNAGEEA <br /> KI7CH[N SINK b DISP IORCIU AIR 51AEA15-0 T U M EA <br /> DIS\VASMER \VALL HLAT[RS-fi T U M <br /> IAUNpRV THAY UNII NUTINS-11 T U M <br /> CIOTHFS\YASN(R t\'APORATIVF COOL[RS <br /> N'A7ER IIkATFN ClO1Hf5 ORY[RS <br /> UNINAI y�NiILATION FAN <br /> ONINKING fOUNTAIN gANGF HOOD � <br /> fIOOR ORAIN AIR MANDUNG UNIT- C F M <br /> VACUU��I1RUK[RS STOVE <br /> NOOF ORAIN$-RAINLFADFR$ M[Ul FlRFPUCE b CNIMNEY <br /> SINK�SFRVICk-NAR ETCI <br /> SU!TOiAI SU!TOTAL 3 <br /> ►EIIMIT 3 /EqMIT 1 <br /> IOTAI FEF f iOTAI FEE f <br /> SIDf YAND 5(TIIACK STR[ET 5[TOACK RUR VAAD St70ACR PIAN CIILCA NUnll{EN PLAN�H[CK FEE <br /> FEE RECEIPT NO. <br /> USF 7.ONf LOi AR[A yAGNT SIIE <br /> GYFS CNO FEES VAWATION FEE <br /> iVP[Of CONSI OCCUPANCY GROUP NO OF DwfLLInG UNIIS <br /> SIZE OF NI�G I.O OF STORIE$ MAX OCC IOAD OUILDINC f^ �^a a � <br /> 7 <br /> PWM11111NG <br /> � '( ZOYE UAS[MENI IIlDRO0AIS RNf 51'NINKlfRS <br /> R[QUINE� AIECIIANIUI <br /> f1Yf5 ❑NO <br /> At►ROVAl1 BY DATF O7MIR <br /> 7 ENVIRONMENTAL CHFCK LIST — <br /> reNnnv u n c. <br /> 1 SUILDING PUNS SEC JOJ(a) <br /> J FIR[ HYD0.ANT TOTAL M <br /> J�.. <br /> � FIRF PNOTECTION$YSTEM p[IIMIT VAIIDATION <br /> 5 GNADINGI[XUVAIION 8 CLfAR�NGILRUtlHINL w��LN PFOPERLY VAIIDATED IIN THIS SPACE�TNI515 YOUR PERMIT <br /> L 6 DRAINACE , <br /> 7 ENVIROr1n1ENTAl IMPACT STATEMENT <br /> B ME�LT11 DISTRICT <br /> APPLICATION ACC.�Y PlANS CMFCNED 9Y APPR FON ISSUANCF BY <br /> q.7.:9 <br />