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APPLICATION FOR <br />°�TM°"�'� �ONSTRUCTION <br />everett PERMIT <br />DEP7 OF COMMUNITY DEVELOPMENT $ERVICES <br />CITY HALI Ii9-B745 <br />EVERETT, WA9B201 �COMBINATION L�BUILDING ❑MEtHANICAL ❑PLUMBING PERMIT NO. <br />•' r,.w�- i v Inn/ �" / - / "'� `^' � w ' /�LO =7 .G L — <br />ANCNIIlCLORD[$ .N�q MAq�00P[55 GILY ZIP PNONE <br />G[NfR�I[ONiPACiOA nUIlA0�RE55 CIiY ZIP pHONf LKEMSEI <br />n1ICM�N1Ul COti1RnC10R M�IL �D�RE55 CIIY 21V pMpN[ IICFNSE / <br />PIVMl1M1GCONINACIOR M�Il�00R65 ❑iY ZIP PHOHF LIC[NSFI <br />CUSS OI \VONK <br />❑NEW ❑ADDITION ❑ALTERATION I�'REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDINGRELOCATION <br />W1U�110N OI wONK <br />s �C n _/�n <br />1`RO�OSID �Sf OI flUIl01�vG /'� V� � <br />�i1Ji � \ /LV � <br />UGAI UtSCRIP110N OI PROPIYIY �SMONN PIl <br />� �0� � � <br />l01 Plp[t� t' f <br />�/ 3 / �:Q.G-q.w-�-a-cl� <br />�t,�e.�J "l,l,a . GS'� <br />���� ���H� 55 n ^�.,� I' <br />. (.L// r �-'� <br />PIUMBING ����� <br />NO. TY�E OF iIXTURE <br />WA1fH CLOSET ITOLIETI <br />U\'AIORY IWASM AA' <br />SMON'fR <br />KIlU1lN SINK 8 UISP <br />DISWASM[R <br />IAUNURY TNAI' <br />C10111E5 �YASH[R <br />UHINAI <br />nRINYINC FOUNTAI <br />fLOON ORAIN <br />\'ANUM NRUKLNS <br />SINK ISLRVICf -f1AR. f TC I <br />SID! YANO SfT1UIX <br />USE 7.Or:! <br />iYPC OI CON51 <br />SIZF GF NIOG <br />�iIACH fOUX COPIE51 <br />il <br />SU! iOTAI <br />PFIIMIT f <br />TOTAL iFF 3 <br />SiRC[T SRIIACK RI <br />lOT AR[A <br />OCCUPANCY GROUP <br />NO Of 5700.1E5 <br />BAS[MENT NIUHOOn1S <br />AKROVAlS <br />� [NVIRONM(NTAI CM[CK UST <br />7 17UILUING PUNS <br />7 fIN[ H1'DRANT <br />� FINE PROIECTION $YSiEM ' <br />S f,NADInCt%U\'AiIONACIEARINGIGRU0111NC <br />6 DRMNAG[ <br />7 ENVIHONMENUI Ih1PACT STATEMENT <br />S HEALTM DISTHIC7 <br />APPI!CA71(�'• nCC. BY PUNS CHEIXfD BY <br />f 1�'S-� <br />9-1�79 <br />\'AUNT 511[ <br />❑YES ❑NO <br />NO OV DWEIIING UN <br />D <br />�1' � D�iE <br />�SSUANCF tlY <br />%U'�-A.(f.Xc.� 1+.w.�t'�t6�.Qs�r.�Sf <br />I HEREBY CERTIFYj!(HAT I HAVE READ ND EXAMINED THI$ AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />OF WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT THf. GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLA�fE OR CANCEL THE PROVISIONS OF <br />�NY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THC PEHFORMANCE OF CONSTRUCTIqN. <br />SIGPIATURE OF CONiNACTOR OR AUTHORI?ED AGCNT DATE <br />x �-e�Gu, � - 72trzcnra-`� ia��/� Z <br />MECHANICAL '�,A-7� 1 <br />TYPE OF EQl <br />AIR COND UNITS-H P EA <br />I{OILIRS-HP EA <br />GAS TIRED �C VNITS-TONNAGE EA <br />IORC[DAIRSV57[M$-flTU b <br />\1'All HtA7kN5-0 T.0 M <br />UNI7 MU1fR5-flTU M <br />IVnPORAINFCOOLCRS <br />CLOTHR DRYIRS <br />NANCCMpO� <br />AIR NANDLING UNIT- C F M <br />M[TAl FlHFPLACF 8 CMIMN[Y <br />CCA NUh117[R <br />FFFS <br />SU/TOi�I f <br />rF�M1T f <br />TOTALFFE f <br />PUN CHECK FEE <br />FkE RECEIPT NO. <br />VAIUAi�ON {EE <br />OUIIDINC 3 <br />PWM111NG <br />MKNANIUI <br />OiHFR <br />PLNAITY UB C <br />SK lONa1 <br />TOTAI <br />►F�MIT VAIIDATION <br />WMEN PROP[RLY VALIDATFD pN TNIS SPACF� TNI515 YOUR PERMIT <br />