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APPLICATION FOR � <br /> tns EveiD��" C O N S T R U C T 1 O h everen <br /> crtr oF � <br /> everett PE RM IT <br /> DEP7. OF COMMUNITY DEVELOPMENT SERVICES <br /> C�TY HAL� 259�D745 - <br /> E\'ERETT,WA9B2J1 �COMBINATION �BUILDING �MECHANICAL ❑PLUMBING PERMITNO. <br /> OIVNIR MAILhppN14 CI11 LP PHONE <br /> wff5��%N4To1L �/Rf�Vv4) G✓+ $ � I/ �A;�n ! �J'Y/ — u'/ B'b <br /> � � ARCMR[C�IOROfSICNfR MAILAOORf55 UtY 21P CHONE <br /> +� T�1.!!S/�O 1[/ �Il V .> S'-' �✓'�C� (U <br /> cEHER�i�+��c�xN Bt^o5 .—/ll�ii�ooRess ,�, g[7,y' a� —V cGe' tv3 33"�� N-b 1 uceNsc� <br /> �v-e v�g r.q�w 5 T`FT�p Sh.�.e.l {�l�e fr� / G- V �'S'} ' j //'�'- <br /> MfOUNIUI QONI0.AQOR n1�IL/.ODN6S r' CIiV l.iP PNONE �ICENSE N <br /> �r �'S r�Lt�1H��N��� ,S�Vc� t`�' ,//L�� �C-�fr—U-�3 Y <br /> �W�111t�G CONi0.AC�0R AIAIt AODR65 UIY 21V PNONE IICENSE� --" -1 <br /> /V¢ W ,bV��lc� �`K5i <br /> [uss o�woxK <br /> C�YtJEW ❑ADDITION ❑ALTERATION ❑REPAIft ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> \'AWAiIOM1Of1\'ORH � �J <br /> ' ��y - 'J-fs-O (r�-, ��1� . <br /> oiscaint� .uK C <br /> �2W ' Q/�/ I� N C' <br /> reovostoust or nmioiNc I HERE�Y CERTIFY THAT I HA�E READ AND EXAMINED THIS AP- <br /> D f'I'I�C �- PLIC�TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> i[cn�oEscairrior+ov raov�arr isHown xttow oa ntrncn rouR mrns� PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br /> � _BPc» .lV�A C✓�S r OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ior_niocK_ov OR NOT. THE GRANTING OF A PERMIT G.ES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF <br /> ,y� LU 5 ��5� �0. �I3 1 , o F Lo T � nNY OTHER STATE OR LOCAL I AW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> DU�'��.c+S Ar y LI,WQ p- Ud ^MB iVT YIl`r� � iIf,NA7UNE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> IOO�DDXI55 [.i- 2d2 -4 � 5-`+- +�� n � <br /> l!�, !�.0 , E✓c=r�,=�r F�Ji�cx. p X � iG.�-� � ���� ,-- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EQUIPMENT FEE <br /> 1YATFN CLOSET�IOLIETI (�,) AIH COND Utii7S-H P EA <br /> OATHTUB NFfNICERAiIONUN175-HP EA <br /> LAVATORY�WASMIIASIN; � C:L� 1101LER5-MP.EA <br /> SHOWFR GA$FIRED AC UNITS-iONNAGE EA <br /> KITCMEN SINK 8 DISP � FONCED AIR SYFEMS-B.:U. M EA <br /> DISWASHER N'AlL NtATFRS-l77 U M11 <br /> LAUHDNY fRAY UNIi H[ATENS-fi T U M <br /> CIOTHES\1'ASHfR [VAPONATIVE COOLENS <br /> � N'A7kRMEATLH r L:ZJ QOiHf50RYFRS <br /> URINAL � VENilUilOY MN �� <br /> UftINKING FOUNTAIN � RANCF HOO� _ ) <br /> FLOOR DRAIN AIR NAND:ING UNIT- C F M <br /> l'ACUUM fiREAKEHS S70Vk <br /> ROOF pRAINS-NAINIkADERS �1ETAL FIRfPUCE 6 CHIMNEV <br /> SINR�SFHVILE-BAR ETC 1 <br /> SUB iOTAL �� �X> SUB TOUL S � �J <br /> PERMIT S - PERMIT 5 <br /> TOTAI FEE S .� TO7AL FEf 3 �'��! <br /> SIOE YAHD SET[IACK STREF7 5[TpACK RUR YARD SETl7ACA PUN CIiECK NUMf1CH PLAN CMECk FEk � <br /> .�'� �` .� �Z.'1� � fEE �j 'f� RECEIPTNO�����j �� <br /> USEZONE IOTAREA � //0��� � / ����- " <br /> VACANI517E (FES VAWATION FEE <br /> �— — � 5 r�3 8 $. , ❑res ❑r+o <br /> TYPE Of CONST OCNPA/NCV GRO HO OF DN'kLIING UNR$ <br /> r.r '`J IJ? '_� t1UIlDItiG S/� �f'1�� � ¢L� J�� <br /> SIZE OF ULDG NO.Of STORIFS MA% OCC IOAU <br /> �J(�XI f)G I .L(i5 riun�nir+c /L(� �.'� <br /> FlNC ZON[ OASEMENT lill)NOUMS �IRf SPRINKLFHS <br /> �_ .,�_ �, �OSin[o� Mrc��nnicni � p t� <br /> APPROVALS BY DATE OTH(8 '� <br /> 1 ENVIRONMEMALCHECKLIST U13C <br /> PENAITY SEC J03�a1 <br /> � eun.owc runs � <br /> 3 fIRE MYDRAN' TOTAL ��l/ _ Asl <br /> !t(' L'C/ <br /> i fIRE PROT[CTION SYSTCh1 PEBMIT VALIDATION <br /> WHEN PROPiRIY VALIDATED(IN THIS SPACEI TMIS IS YOUR PERMIT <br /> 5 GNADINGLXUVATIONbQtARINGfqUdNING <br /> b oa�u+ncc �f�r�� REti-liJl.� �Z�-t���f(C/�1.._ <br /> 7. ENVIRONMENTALIMPACTSTATEMFNT (��.-� �`� ,T <br /> 1_ Y Tv �a� G� [`/�i�...tt�/-� <br /> B MEALTM DISTftICT � � ^ ' �f� <br /> APPLICATION ACC BY PLANS CMECKED BY APPR. fOR ISSUANCE HY �� '�'lL"�-{����C�L- �-�%�Z��/��--(G(L <br /> �:,; ;� G C . <br /> , <br /> 9174 — /t/jL(L�iL7'�; [.vaTc�z-_ <br />