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�r --� <br /> APPLICATION FOR ��«<n <br /> �^.E~ro'"" CONSTRUCTION <br /> cin oF <br /> everett PERMIT <br /> DEPT OF COMMUNITV DEVELOPMENT SERVICE$ � <br /> CIT1� HALL 259�8745 , <br /> EVERETT,WA98201 ��OMBINATION I�BUILDING ❑MECHANICAL ❑PLUMBING PERMITN <br /> M�IL�OOX65 .��,A CII\ ///JJJ ZI%' �P�%N[ <br /> ON'NER /� ��/ /{�//�l���UO� �� �c 2t- ,Z 52-�6 r`� <br /> /1��'-�d�i" ,��".f-:/ e�a..�o-�eSC -..i <br /> ARCHR[QORD N!R <br /> M1InII ADDRF 55 ��tY <br /> ���,,,� �.� ,�lA � ����_7_-��1.� .�� .fe���-� -� 9�2�� �37-2�6� <br /> (.[N'PA CONI31�Ci0R � ,p <br /> M ILADDR65 CIIY ZIP YNONF <br /> ����V .i ��. � r"� �3/� /07'����� t/l�/1a.�'�/� 33T-1lIGt" Y/,�N.C�De?�y�� <br /> �+ MAII ADDPEST CIIY 21P PNONE IICEN$E/ ^ <br /> � MfC11AN1UlCONIN�CIOR , <br /> PIU��PrvGCOH�AACIOR MAIIADDR6S <br /> fI1Y 21P PNONE llC[NSE� <br /> [�A55 Of N'ORK <br /> ❑f:EW IHI.ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE BUILDING RELOGATION <br /> \'AWAiION f N_/'00.K <br /> � J OOOfO <br /> oescx�envoyK � � . � <br /> �Roa��fl�ioi�c I HEREB RTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> / PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �L�S (c� C P. PROVISIONS OF LAWS AND ORDINANCE$GOVERNING THIS TYPE <br /> iE���PiION Of VROPENtYISNONN fl[LOW OR�1TACN IOURCOPt61 OF WORK WILL BE COMPLIED WITH WHETHER SP[CIFIED HEREIN <br /> ia� BIOCK�Oi �VE OAUT OR TYATO'VIOLOATE OR CANCDEOL THE PROVISIONS U <br /> � _Z � ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> / SIGNATUR OF CONiRACTOR OR AUTHORIZED AGENT DATE <br /> IOB�DD0.65 O U 4�C � A�G s <br /> MECHANIGAI <br /> PLUMBING FEE <br /> TY�E OF FIXTURE FEE NO. TYPE OF EQUI�MENT <br /> NO. ��p�OND UNITS—H P.EA <br /> W�IfN ClOSET ITOLiETI REFRICERATION UNR$-N.F.[A <br /> RAIHTUA BOIlERS-HP EA <br /> IAVATORY lWASH BASIN) GAS FIRF��C.UNIT$-TONNALE EA <br /> SNOWFR FORCED AIR$YSTEMS-B.TU. M EA <br /> KIiCH[N SINK 6 DISP N'ALl MEATERS-B.T.0 M <br /> DISIYASMEH <br /> UNITMEATERS-OTU. M <br /> IAUNDRY T0.AY (y�ppRATIVE COOLEH$ <br /> CLOTIIES W�SHFR ��OiMFS DRYFRS <br /> WAT[R HFATER yENTILATION FAN <br /> URINAL RANGE HOOD <br /> � URINK�NG FOUNTAIN <br /> AIN HANOLING UNIT- C.F M. <br /> � FLOOR OR�IN STO�E <br /> VACUUM BRUK[RS METAL FBEPUCE 8 CNIMNEY <br /> ROOF �RAIN$-RAINIEADERS <br /> SINK�5[0.VICE-BA0.,CTC 1 <br /> � � Tu <br /> SU�70TA1 s <br /> Y <br /> SU�TOiAI ►ElMli s <br /> tERMIi s 707AL FFF � <br /> TOTAL IEF s PLAN CHECK FEE <br /> SIDF VAHD SCTOACK STREET 5[TRACK RCAR Y��D SETOACK PLAN CNCCK NUMBER FEF T� RECE��NO.� <br /> (p (`'' �3 /ot 0�o /.�� 6 <br /> LOT ARU VACANT SITj. YAIUAiION fEE <br /> USE ZONF_ fFES <br /> � / ❑YES �� <br /> TYPE OF CONST OCCUP'AINCY AGROl1P NO OF DWELUNG UNITS <br /> -tT�,�„� �DJ•`tN I`3 I BUILDINC s� <br /> r MA% OCC IOAD y <br /> S�ZE OF PLOG NO.OF STONIES G. OU <br /> — PWMOING <br /> { ADDN Ico S.F I � <br /> FIR[ZONE BASChIENT IIIUROOAIS REQUINEDK/lERS MFCHANIUL <br /> r � — f7YF5 GINO <br /> A►�ROV�LS �Y D�iE OTNER <br /> UBC <br /> 1. ENVIRONM[NTAL CMFCK LIST PFNAITY SEC.JOH�) <br /> 7. BUIIDING PlANS TOTAI <br /> ��Z � <br /> � 7 FINF NYDRANT <br /> �[I1MIi VALIDATION <br /> � FiREPROi[C7�ONSYSTEM WHENPpOPfRLYVAI�OQEDfINiNI55P��E1i11151TVOU0.PFRMIT <br /> 5 GNADINGII%CAV�T�ONBCI[ARINGIGRUBNING <br /> fi DRAINAGE <br /> 7 FNVIFONMENiALIMPACTST�TEMENT <br /> e. NFALTH DIStRIQ <br /> �pPIICATION�CC.6Y PLANS CMECKED BY APPR.FOR ISSU�NCE 9Y <br /> S'� Fl-&111`� C. , c:. <br /> 9�1�79 <br /> ♦ ' <br />