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APPa-.fCATION FOR e�e,�„ <br />everett C`� PERMITTION e <br />DGPT. OF COMMUNITI' DEVELOPMENT SERVICE$ <br />CITY fIALt 259�8745 <br />eveaeti.wnvezot ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBINC PERMIT NO. <br />o�v'��E1x n�uinouaess enr nr ruo�ve <br />C��L.Oi.��-+ce:. P����7�.� c �/'.� /U /z`-U/7� C�n2iF",2'.-i 4�itY /`vFiuY'�% �a->':!:/ .S i .j ' '7C23 <br />neaaTecr oa onicn�u Mea nooei s arr zir r�wvc � <br />MNL ADDNf55 <br />L1i1�8LS <br />CITY <br />cyui <br />PHONC �IC(NSE k <br />�%� iJi�fi70G f2' <br />PIIOrvE tICENS! � <br />PtUMpINGCONipAC10R nNILADUNf55 CpY (IP CIIOu[ UCFNSEN <br />ClASS OF \1'ORK <br />. ❑NEW ❑ADDITION <br />vnwnnoN or ��ve� <br />s <br />oE scam[ wox� <br />PROPOSED 11Sl OF IIUIIDING <br />❑ALTERATION ❑REPAIR 11J4EMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑�UILDING RELOCATION <br />l[f.�L U6CNIP110N Of PpOPLR1Y IS11011'N IitION' OR �TT�CII IOUR COPtF51 <br />ioT,Lri�niocr:_o� OF�/rnT oF G,� <br />�G%t'F��/ �>.c.�i.f..f %.�L.aci.5 . .C7i<�: <br />;OP ADDFI SS <br />PLUMBING <br />NO. TYPE OF FI%TURE <br />\VATER CLOSET ITOLIEiI <br />IlATMTU6 <br />LAV�TORYpVASH 6A! <br />SNOWER <br />KITO1(N SINK A DISP. <br />LAUNDRY TNAY <br />\VA7FR MEATEN <br />DRINKINC FOUNTAIN <br />ROOR DRAIN <br />\'ACUUA7 l7REAKERS <br />ROOF DRAINS—HAINLEADERS <br />SINK 6ERVICk—AAR. ETC 1 <br />SIDE YARD SEi11ACK <br />USE ZONE <br />TVPE OF CONST. <br />512E OF DLDC. <br />fBE ZON[ <br />r <br />FEE <br />I HER[BY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLIC�TION �ND KNOW THE SAME TO 6E TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THI$ TYPE <br />, OF WORK WILL 13[ COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PER�tiT DOES NOT PRESUM[ TO <br />GIVE AUTHORITY TO VIOLATE OR C�NC[L TliE PROVISIONS OF <br />�NY OTHER STATE OR LOCAL LA\N REGULATING CONSTRUCTION <br />OR TH[ PERFORMANCE Of CONSTRUCTION. <br />SIGNAT�Rf OF CONTRACTOR OR AUTHORIZED AGCNT DATE �-7�Q� <br />( <br />r <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT <br />AIR COhn UNITS—H P. kA <br />R[fRICERATlOY UNITS—H P. fA <br />ooueus—��i r. �n <br />C.ASFIHLUAC UNITS—TONNAGECA <br />fONCI U nIR 51'576�15—O.T.U. M kA <br />11'AI.Lf11.A1LR5—f1T� A7 <br />UNRHLA�INS-117U. h1 <br />f\NI'ORAi1VL COOLlRS <br />CLOIHFS ORYLNS <br />VLNIILA710N FAN <br />RANCI HOUD <br />AIR HANULING UNI7'— C FM. <br />S70\'f <br />�Vf7AL IIRLPLAC[ A CHIMNCY <br />PERMIT S <br />TOTAL FFF 3 <br />STR[fT $C7UACK NkAR VAND SFTI4ACK PIAN <br />LOT AREA VACANT tlif <br />❑YCS �NO <br />OCCUPANCY GROUP NO. OF DNCLLING UNITS <br />NO. <br />RASEMENT <br />APPROVALS <br />L ENVIRONMLN7AL CHCIX LIST <br />2. DUILDING PUuS <br />3. FIRF. HI'DRANT <br />4. FlR[ PROTCCTION SYS7EM <br />5 GHApING/IXGVATIONgCLfANING;GNUIIIIING <br />6 DRAINnGE <br />7. CNVIRONAt[NTAL IMPACT $iAl(MINi <br />B HFM7HpISTNI('7 <br />. i � b . i � .'. � L. I' :A �U � i I I. �_, ❑ <br />OCC LOAU <br />tkQUIR[D <br />lYfS flNO <br />BY DATE <br />IIUIIUING <br />I'LUMflING <br />A�LCHANIGL <br />OTHEH <br />PENALTy <br />SUB TOTA1 f <br />PERMIT s <br />TOT4l F[E f <br />NUMOIN <br />fk! <br />FEES VALU/ <br />S <br />U.17.0 <br />SCC. 30J(a) <br />PUN CHECK FEE <br />� RECLIPT NO. <br />TOTAL I � <br />PERMIT VALIDATION <br />N'H(N PROPIRLY VALIUPTEU (IN 7H15 SPAC[) iH15 IS VOUR P[RMI7 <br />FEE <br />