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I <br />;'�,rIIL t h I�JN FOIt,��` <br />CJNS•TkF,JC*TION <br />everett PF RINA IT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVEREIT, WA98201 [-]COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />HCENSEIf <br />/i/L✓lt4K L(/HJJ-C� <br />�GT.�O+C %L1'✓ <br />-4F�z� <br />2SY-y/7,e <br />let g"i.-U-.1Lt <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY -. <br />LIP <br />PHONE <br />LICENSER <br />� /I�os <br />ITS /3 0/p L/� G2�GkK,.�r� <br />P.J•lJOK✓Zs�OD <br />3G y -✓/oa <br />PIVMB//i CONTRACTOR <br />MAIL ADDRESS T <br />CITY <br />ZIP <br />PHONE <br />LICENSE F <br />4 .�a 12- ✓✓� <br />D! 3 3 d� fit ✓L/C C <br />C (/ <br />Y�'ro/ <br />.?i7. 1VV.l oZ.Z1'c/ <br />G� ,�y TS <br />CLASS OF WORK <br />A(..L-/4✓ �. <br />Mll.\1. M.nnrrinwl <br />I�I I��� I-� <br />I IAI TCO ATVIM I IOCD... I nCUni <br />I--� 1-'1 <br />ITVTM ICFMrC I c,l . <br />-I <br />M_ .DerC 1111111I TLMr. RCI nrATIFTN <br />VALUATION OF WORK <br />S� <br />_�)D ODD <br />DESZRIBE WORK <br />A-- i <br />PROPOSED USE OF BUILDING <br />�ti..k.c.-c <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 AND 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 V!OLATE 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 />X /n-J—✓a <br />LEGAL DESCRIPTION OF PROPERTI'(SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT BLOCK _OF <br />• <br />JOB ADDRESS <br />NUMBING <br />MECHAN AL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OI EQUIPMENT <br />FEE <br />WATER CLOSET IIOLIET) —_ <br />(7(7 <br />AIR CONE. UNITS-Y..P EA <br />BATHTUB - <br />REFRIGERATIONUNITS-HT EA <br />LAVATCBY (WASH BASIN) <br />C.Jr/ <br />BOILERS-H.P. EA <br />SHOWER <br />GAS FIRED A.C. UNITS -TONNAGE EA <br />KITCHEN SINK b DISP. <br />FORCED AIR SYSTEMS-B.T.U. M EA <br />DISWASHER <br />WALL HEATERS-B.T.U. M <br />_ <br />LAUNDRY TRAY <br />UNIT HEATERS-B.T U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />T <br />2) 0 <br />CLOTHES DRYERS <br />_ <br />UR;NAL <br />/ <br />VENTILATION FAN <br />C <br />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C.F.M. <br />_ <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS-RAINLEADERS <br />METAL FIREPLACE b CHIMNEY <br />SINK (SERVICE -BAR. ETC.) <br />" % ow G UN/ <br />CP <br />OG <br />_ <br />:f J <br />SUB TOTAL <br />SUB TOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />S <br />Q <br />TOTAL FEE S <br />I <br />�1U <br />SIDE YARD TBACK <br />��/f, <br />STREET SETS ACK <br />REAR YARD SET BACK <br />PLAN CH' CK NUMBER <br />`•� <br />�-31z <br />PLAN <br />FI r�Z�G 95 <br />-L I <br />CHECK FEE <br />RECEIPT NO <br />USE ZONE <br />C—I <br />LOT ARIIA <br />VACANT SITE <br />OYES gNO <br />FEES <br />VALUATION <br />FEE <br />- <br />TYPE --OF CCON.ST1 <br />—^N <br />OCCUPANCY GROUP <br />g�7 <br />NO OF DWELLING UNITS <br />` <br />BUILDING <br />N���• <br />SIZE OF 1(FTG <br />2e x q 0 <br />NO. OF STORIES <br />I <br />MAX. OCC. LOAD <br />SIT <br />PLUMBING <br />FIRE ZONE <br />OASEMENT <br />BE OF'.:OAES <br />— <br />FIRESPRINKUERS <br />QUIRED <br />YES ❑NO <br />MECHINICAL <br />-- <br />Q <br />l <br />ic1G <br />Cl <br />APPROVALS <br />III <br />FATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY s <br />U B C <br />SIC lm(a) <br />Z. BUILDING PLANS <br />TOTAL <br />-- <br />O <br />7 <br />T.FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />,YHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />S. GRADINGIE%CAVATION b CLFARINGIGRUBNING <br />5. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8, HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />V • `. <br />APPR. FOR ISSUANCE BY <br />—J <br />9-1.79 <br />