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, <br /> tA�Erupmn e�� <br /> °�TM°F CvNSTRUCTION <br /> everett PE RM IT <br /> DEPT.OF COMMU�ITY UEVELOPMENT SERVICES <br /> CITY HALL 259�8745 <br /> EVERETT,WA9B207 ��OMBINATION C�'/UILDING ❑MECHANICAL ❑PLUMBING PERMITNO. <br /> OWNlR n MAII�DOAfSS CIiY 21P YItOYf <br /> ,11ol:�i / 5 /C, /�A✓, rS �l �JS �/ C` ���T !�Pii.:.� ln,�ilJl-•5t�c'] <br /> ARCHIIE[T OR OESICMR MAII�pDR[55 CITY 21P PNONf <br /> GI Fll�lC iR�C10N M�Il�OOR[55 CIIY ZIP PNON[ llC[NSEI <br /> / Q[�L�.S-� <br /> 'J �� � s .L(.rSo.c•A� (�t:,Z.�i I�s% S�i n,�� -�21s1r_�3✓./�4 7.5�,27D 6S`/ '�<��i :�7o��J-.� <br /> WfCH�NiGI CONiR�CIOR M�II�DDRRS CItY 21P PNONE UCENSE I <br /> PIUMPIHG[ONiR�CtON MAII e00N65 CRY 21P VNON[ LICENSE I <br /> C1�55 f WORK <br /> �W ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> \'AIUAIION Of WORR <br /> + �3UC� <br /> 0lSCRIPF WORN <br /> r� .si q _ 1 (I�Q (' <br /> vRoaoseous�oi nuimiNc I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP• . <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> ILGAl0E5CNIPtIDNOf PNOVERLYISNONN BEIOW OR e1T�CN IOURCOPRSI PROVISIONS OF LAWS AND ORDINANCE$COVERNING THIS TYPE ' <br /> ioi�nioca_o� � 6'..: l,o% .g ;i�,,,, yv 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 /> � , ti�c..i s' r < <.cc < <.e' '�: 13 d � ANY OTHER STATE OR LOGL LAW REGULATING CONSTRUCTION <br /> I OR THE PERFORMANCE OF CONSTRUCTION. <br /> L �ni • 3O i Sv�I �(r SICNATUIFE OF CONTRACTOR OR AUTHORI2ED ALFNT DATE <br /> IOPnDDREA / � �� <br /> �I�r s�i �L.�., ST `z v1.«_� x���-,,. ��-c.� /U��-r`l�7 <br /> ►LUMlING MECNANIUL <br /> NO. TY�E OF FI%TURE FEE NO. TY►E OF EQUI►MENT FEE <br /> WATfR ClOSET�TOLIFTI AIR COND UNITS—H P.EA <br /> BATHTUB 0.EFRIGFRATION UNITS—M P EA <br /> UVATONYIWASHBASIN) BORERS—HP E� ' <br /> $HOWFR CAS FIRED�C UNITS—TONNAGE EA <br /> KITCMEN SINK 8 DISP fORC[O Alq SYSTFM$—B.T U M EA <br /> DISWASHER N'lLL MFATENS—BS.0 M � <br /> UUNDRY TRAY UN�1 HEATERS—B.T U. M <br /> CIOTNES wA5HE0. N'APORATIVE COOlE0.5 <br /> WATER MEATER CLOTNFS ORVFRS <br /> URINAL VENT�LAiION FAN <br /> DRINKING FOUNTAIN RANGF MOOD <br /> FLOOR DRAIN A�R MANOIINL UNIT— C.F M. <br /> VACUUM BRFAK[RS STOVF <br /> ROOi DRAINS—NAINlUOfRS ME1AL FIREPLACF 8 CMIMNEY <br /> SINK�SERVICE—BAR.[TC� <br /> SU�TOTAI fU�TOiAI � <br /> ►ERMIi { ►F�MIT f <br /> iOTAIiFF f TOTAIi[F � <br /> SIOf VARD SCTflACK $TRfET SCTB�CK RUR VAND 5[TBACK PUN CH[CK NUMBFR PLAN CHECK FEF <br /> iEE RECEIPT NO. <br /> USE 20NE LOT AREA yACANi StIE <br /> ❑YES ❑NO FFFS � VAIUAiION i[E <br /> TYPE OF CONST. OCCUPANCY CROUP NO.Of DWELLING UNITS <br /> BNLOINC 1 <br /> SIZF OF BLDG. NO OF STORIES MA% OCC IOAD <br /> PIUMBING <br /> fIRE ZONE BASUIFNT OLDROOMS FBF SPRINKLER$ <br /> REQUIREO MFCMANIGL <br /> OVES f7N0 <br /> AR'�OVAIf �T DATF OTMFR <br /> 1 FNVIRONMENTAI CMfCK llST U.BC. � <br /> PENALiY SEC.l0Aa1 <br /> 2 BUILDINC PUNS <br /> ] iIRE HYDRANT TOiAI <br /> 1 <br /> 1 {IRE PROTFCTION SYSTEM fELLMIT VAI�DAiION <br /> 5 GNADINCIF%CAVATIpN 8 CIEARINGILRUtlBING WNFN PpOPERLY VAUDATCD pN THIS SPACE�THIS IS YOUR PERMIT <br /> � 6 DRAINAGE <br /> 7. ENVIRONMFNTALIMPACTSTATEMENi <br /> ! MF�LTH DISTRICT <br /> APPLICATtON ACC.RY PUR$CNFCKFD BY APPR.iOR ISSUANCE BY <br /> v � <br /> . �, <br /> 9 7 79 <br />