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IA,EY,rgwn APPLICATION FOR eleretE <br />DLYDF CONSTRUCTION <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />FVERFTT.WA98201 (]COMBINATION BUILDING ]MECHANICAL ❑PLUMBING PERMIT NO. <br />01%NIR MAIL AI MISS CO, 711, PHO" <br />GReg oX' al�J3 u.PE�vIc Av, C-vI� 3S'7 -a- 119r <br />ARUUII�UR OTMGrNER MAIL ADDRESS COY ZIP PHONE <br />An id/ , aw <br />(.INIRAI CONTRACTOR MAIL ADDRISS CITY 71P PIIUNE LICENSE <br />N UMRING CONTRACTOR MAIL ADDRISS CITY ZIP PHONE LICENSE <br />(LASS 01 WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GARAGE ]BUILDING RELOCATION <br />VALUATION OF WORK <br />�k0. <br />DHI MILLI R,,I I••NK <br />PROPOSIO USE 01 BUILDING <br />1 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 GOVERNING 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 REGULATING CONSTRUCTION <br />OR Ttit . PERFORMANCE OF CONSTRUCTION. <br />SD;NAHFRI UI I ONIRA( I�IJ.Uy� AUII )RIJEU AGENT DATE <br />-pI l� <br />x 7 <br />ITGV DIY N I'DOV OF PROPERTY 1511UWN RHOW(1N AilA(N IOURCOPHSI <br />• E� <br />Lo IOCK�OI <br />E� <br />Gh7 d t �/� i % .».^ C e '� <br />/' <br />♦OAsI "s [ �i, (,' (� <br />IUD AUUNi t, <br />C� v a t <br />PLUMBING <br />"N NICAL <br />NO. <br />TYPE Of FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TODEiI <br />SIRCOND UNITS —TIP EA <br />RAOITUB <br />RIIRIGIRA110N UNIIS—TIP FA <br />I AVATORY (WASH DASIN) <br />BOILERS—H P LA <br />SHOWER <br />GAS FIRFDAC UNIIS—TONNAGI IA <br />KITCHEN SINK A DISP <br />IUR(ID AIR S)STFMS—II TU KI IA <br />UISWASHFR <br />WALL HIAIIRS—BTU M <br />IAUNURV IRA)' <br />UNIT HIATIRS—II I L) M <br />( 101111 S WASHER <br />I VAPORAIIS9 (001IRS <br />WAFER THEATER <br />CI(HHIS DRYIRS <br />URINAI <br />V'I NTHAIION IAN <br />DRINKING IOUNTAIN <br />RANGE HOOD <br />It ()OR DRAIN <br />AIR HANDLING UNIT— C I M <br />VACUUM BREAKERS <br />S10V1 <br />ROOI DRAINS—RATNIU) RS <br />MI TAT IIRE NALI ACHIAINIY <br />SINK ISERVICL—TSAR. [ICE <br />SUB TOTAL <br />SUB TOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL It[ <br />S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBIR <br />I/ <br />-a /// �uC. / <br />PLAN <br />ill 93 <br />l71 <br />CHICK IT[ <br />ELECT c—CT <br />f.5J— <br />USE ZONE <br />l01 AREA <br />(00-") <br />VACANT 511E <br />❑VIS CNO <br />TEES <br />VALUATION <br />THE <br />TIP[ Of CONE ST <br />IJ <br />OCCUPANCY GROUP <br />14) — I <br />NO Of DWELLING UNITS <br />N % <br />BUILDING <br />S <br />SIZE OF BLDG <br />^ <br />`V VZ <br />NO Of STORIES <br />I I <br />MAX OCC LOAD <br />I <br />PIVMIIING <br />FIRE ZONE <br />BASEMENT <br />I <br />III DROOATS <br />I <br />FIRE SPRINKLERS <br />REQUIRED <br />F1Yf5 N11CU <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U BC <br />SFC )UI(a) <br />7 BUILDING PLANSQi% <br />is , <br />TOTAL <br />) FIR[ HYDRANT <br />a IIRL PROTECTION SYSTEM <br />S GRADINGII XCAVAIION B CU ARINGIGRUHRING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDAT FD (IN THIS SPACH THIS IS YOUR PERMIT <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT SIATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />s <br />PLANS CHECKED BY <br />JE.r, <br />APPR. FOR ISSUANCE BY <br />91 79 <br />