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a,' c II(E��vcErgre.H�� <br />cJNSTL RUCTION IA <br />everett PERMIT i� <br />DEPT. Or COMMUNITY 7F,VELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />ZIP <br />OENERALCONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE N <br />7J,3—o/ <br />(-" i/v <br />9s J' <br />-eF Kz� <br />r/.PJo6 <br />.�s'Y-1�i9/ <br />/Lt "4 ,fc 3✓ Le <br />1ULa✓l ..� ./J� <br />MECHANICAL CONTRACTOR <br />,Qex <br />MAIL ADDRESS <br />CITY, <br />JJpo <br />Yd'/AJ_ ZIP <br />PHONE <br />LICENSE N <br />4vx <br />Za /i /� <br />L/� �' <br />4, 41Z <br />a�,<as�oo <br />3� y -✓ioa <br />_ <br />Ze e <br />PLUMBI CONT1RACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICFNSEN <br />(i .a <br />CLASS OF WORK <br />,XNEW ❑ADDIT;ON <br />❑ALTERATION LIREPAIP. <br />❑DEMOLITION ❑FENCE ❑SIGN <br />❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />f �) n 6O0 <br />DESCRIBE WORK <br />r / 1 14, <br />/7n iJ Ci / �c <br />PROPOS:D USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS ANC ORDINANCES GOVERNING THIS TYPE <br />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 />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE CONTRACTOR OR AUTHORIZED AGENT DATE <br />LEGAL DESCRIPTION LF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT _BLOCK -_OF <br />• <br />JOB AJCRESS <br />PLUMBING <br />MECHANIfAL <br />NO. <br />TYPE Of FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOLIETI <br />UCJ <br />AIR COND. UNITS-H.P. EA - <br />BATHTUB <br />REFRIGERATION UNITS-H.P. EA <br />--� <br />LAVATORY ("'ASH BASIN) <br />CJU <br />BOILERS-H.P. EA <br />SHOWER <br />GAS FIRED A.C. UNITS -TONNAGE FA <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS-B.T.U. AT EA <br />DISWASHER <br />"'ALL HEATERS-B.T.U. A <br />LAUNDRY TRAY <br />UNIT HEATER5-B.T.U. M <br />CLOTHE i MASHER <br />EVAPORATIVE COOLERS <br />/ <br />WATER HEATER <br />JRINAL <br />QO <br />CLOTHE'.DRYERS <br />VENTILATION FAN <br />O <br />3KINKING FOUNTAIN <br />RANGE HOOD <br />I _OOR DRAIN <br />AIR HANDLING UNIT- cum <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS-RAINLE ADI: RS <br />METAL FIREPLACE & CHIMNE:Y <br />SINK (SERVICE -BAR. LTC) <br />o S % cm /G V•V"- <br />w <br />f/ J — <br />SUBTOTAL <br />SUBTOTAL $ <br />PERMITf <br />PER 3 <br />70TA1. FEE <br />TOTAL <br />f <br />0 <br />TOTAL FEE f <br />U <br />SIDE YARD 5kTBI,CK <br />/� ^ <br />STREET SEER CK <br />♦ � A <br />f� <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />�^ � <br />y <br />PLAN <br />I LI '('n- Is <br />CHECK FEE <br />RECEIPT NO. <br />USE 20NE <br />C_ .--.I <br />LOT AREA <br />VACANT SITE <br />DYES 9NO <br />FEES <br />VALUATION <br />fEE <br />TYPEOFCCONST <br />I_ AJ <br />OCCUPANCY GROUP <br />3-2' <br />NO. OF DWELLING UNITS <br />BUILDING <br />SIZE OFFL1.1ff <br />7 S j y Q( <br />NO. OF STORIES <br />' <br />MAX. OCC.gLOAD <br />547 <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />DROOMS <br />FIRE SPRINKLERS <br />R QUIRED <br />YES ❑NC: <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />T. ENVIRONMENTAL CHECK LIST <br />PENALTY S <br />U.B.C. <br />SEC. 303(a) <br />2 BUILDING PLANS <br />TOTAL <br />3. <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />5. GRADINGIEXCAVATION & CLEARINGIGRUBBING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8 HEALTH DISTRICT <br />