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. , <br /> y''`° APP�.ICATION FOR <br /> ��e�ett <br /> C(. �� STRUCTION � <br /> ever�tt PERMIT . <br /> DEPT.OF COn1n1UNITY DE\'(InP�1ENT$ERVICES <br /> CITY HALL 259-8745 <br /> EVER[TT,\NA98?01 �]COMBINATION ❑ BUILDING ❑MECHANICAL ❑PWMBING PERMITNO. <br /> or:nta nun nooutss cnr Zir r��out <br /> pqy�p MT4n�iy�por dA911 ilnl awar[+ F.v�:rPf't QR9f11 ?59 9491 <br /> nflCllliECi OR DESIGNkR ANII ADDNI55 CIiY ZIP PMON[ <br /> GWLFAICONiXAC10X A1All�OD0.[55 fliY ZIP PHONC LIC[NSfN <br /> Hanr7y Bu' 8 Ev��rett 98206 L59-1966 NA—ND-1'II-236PD <br /> n1FOlnl:IGL[ONIR�CIOR M�II AOOR65 CIIY LIP PHON[ LIC[NSE 11 <br /> PW��IIIKG CONIRA[iOR M�IL AOURF55 UTY ZIP PMON[ LIC[NSF N <br /> CONEW,o�AOADDITION ❑ALTERATION �REPAIR ❑DEh10LITION ❑FENCE ❑S�GN ❑GARAGE ❑UUILD�NGRELOCATION <br /> \'AWAIION O�\\'ONA <br /> S <br /> oEscHin�aon� Rr��lo�r <br /> New hot roof aint trim install A new toilet and some trim work <br /> vxovoscuuu or nunowc i HERE�Y CERTIFY THAT i HAVE RE�D AND EXAMINED THIS AP- <br /> PLICATION .4ND KNO\N THE SP ME TO 6E TRUE AND CORRECT ALL <br /> l[GAL06CBIPLIONO(PPOPLRtY�51101VNUELO\1'OR�TTACNIOURCOPIE5) PROVISIONSOFLAWSAVDO� JINANCESGOVERNINGTHISTYPE <br /> OF WORK WII L UE COMPI.IED �VITH WHETHER SPECIFIED HEREIN <br /> tor uiocK_or OR NOT. THE GRANTING OF A PE2MIT DOES NOT PRESUME TO <br /> Lota 43-47 Hlock 18 less 4' for alley GIVE AUTHORITY TO VIOLATE OI'. CAhCEL �tHE PROVISIONS OF <br /> ANY OTHER STAT[ OR LOCAL LAW REGULATING CONSTRUCTION <br /> �P'� • OR THE PERFORMANCE O�CONSTRUCTION. �. <br /> SIGNATURE OF CONTRACTOR OR AUTlIOR ZED AGENT DAiE <br /> ionnooa[ss � `�/� f—�Q-�U <br /> 4820 Delware X L:C-�LCo �._ <br /> PWMBING MECHANICAL <br /> NO. TYPE OF FI%TURE FEF NO. TYPE OF EQUIPMENT FEE � <br /> \\'ATER CLOSEI ROLIET) AIR COP1D UNITS-HP. CA <br /> 17ATHTUO N[PRIGLRATION UNITS-H P.lA <br />� UVATORY�WASHP" v) OOIlERS-HP. EA � <br />� � SMO��EN GAS FIHLD AC.UNITS-IONNAGE EA <br /> I" KITCHEN$INK h DISfl FORC[D A�R 51'FCAI$-11 T.U. M EA <br />�I' �ISWASHER ��'ALL Hf�\7LH5-17S U M <br />;,� V UUNDRY TNAY UnIT HCAT[NS-tiJ U. n1 <br /> ClOTM6\VASHER kVAI'ONn71VE COOL[RS <br />� CLO7HC5 IJRVfRS <br />��� \YATER HEATEN <br />� URINAL Vf M1i11.A710N fAY <br />+� DRINKINGFOUNTAIN HANGLIIOOD <br />� FLOOR DRAIN AIR lIAtiULING UNIT- CF.M. <br /> I, VACUUAI�REAKERS STn���. <br /> ROOF ORAINS-RAINLEADENS MCiAL FIRkPUCf h CHIAWEY <br /> I� SINK(SCRVICFUAR,ETC] <br />� SUB TOTAL SUB TOiAL s <br /> PFRMIT S PERMIi S <br /> I TOTAL FFF S TOTAL FEE f <br /> SIDE YARD SEiDACK STREET SCTIInCK RkAR 1'nRU SETI7ACK PLAN GNtCK NU�1[iLR PL\N CHECK FEE <br /> I FfE RECEIPT NO. <br />�I USE Z04C LOT AREA VACANi 5RF FFES VALUATION FFE ^ <br />� ❑Y6 ❑NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OP D\VLLLING UNITS <br /> I� RUILDING f <br />( SIZC OF OLDG. NO.OF STOHI[5 MA%.OCC.LOAU <br /> PWMI4ING <br /> f <br /> FlRCZONE 11ASEMENT B�UNOO��B R UUINCUnLRS M[CNANIC1l <br /> flYlS I".NO <br /> APPROVAlS BY DATF OTIiEN <br />� <br /> 1 CNVIRONMCNTAL CH[CK LIST ���Nn��Y UDC. <br /> SEC. JOJW) <br /> 7. OUILDING PlANS <br /> TOTAL <br /> 7 FlR[ HY[1RANT <br /> a FlNE PROTKTION SYST[M PERMIT VALIDATION <br /> WHIN I'ROPI RI Y\'nIIDAT[U ON TIIIS SPACE�7HI5 IS YOUR PERMIT <br /> 5 f,NADINCi1XCAVATIONFI'LIndINCIGRU11171NG <br /> 4 DRAINAGf � <br /> 7. LNV!flONM[NTALIMPACTSTATEMENT <br /> 9 IIfAl7H D6TNICT <br /> rl9lh '.Ih�'���i I�1 P� •A.illl�`II� R1 �I'P41t1hK•.l'.AAtlPl <br />