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APPLICATION FOR <br />theEwrom° LO N ST RU CT IO N <br />CITY OF <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 <br />EVERETT, WA98201 ❑COMBINATION ❑ BUILDING <br />R <br />❑MECHANICAL <br />CITY <br />evlretl <br />XPLUMBING PERMIT NO. <br />� <br />ZIP PNONL 3��I J� a� <br />F <br />'ILMBINC CON I RACTOR �•� ��%-A U' �Qn �l \M1 d`Iv SJJ I <br />Rohi n5on PI Lim/ l/YU M W W <br />ON <br />:LASS OF WORK OF WOR� <br />❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE BUILDING RELOCATE <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />Y 13 <br />DI SCRIBE WORK <br />PROPOSED USE OI BUILDING <br />LEGAL DESCRIPTION OF PROPERTY ISHOW N BE IOW OR ATTACH FOUR COPIES) <br />LOT �FLOCK� OF <br />PLUMBING <br />USE <br />CLOSE <br />SINK dd <br />ER <br />TRAY <br />DSINKING <br />FLOOR DR <br />VACUUM <br />ROO' CB <br />SINK OAR <br />of <br />OP <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 SPECIFIEC HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />AUTHORITY TO VIOLATE OR CANCEL THE A YEPROVISIONS <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION, <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE (�-g 1 <br />MECHANICAL �F <br />TYPE OF EQUIPMENT <br />FEE <br />FEE <br />NO. <br />OF FIXTURE <br />AIµ COND UNITS—H P EA <br />)LIFT) <br />RE FRIGERATION UNITS —HP EA <br />BOILER) —HP fA <br />BASIN) <br />CAS FIRED AC UNITS -TONNAGE EA <br />IORCED AIR SYSTCMS-H T U M EA <br />)ISP <br />N'ALL HEATERS -BTU M <br />UNIT HEATERS-B T U M <br />EVAPORATIVE COOLERS <br />T <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />FAIN <br />I. HANDLING LINE I- C.F M. <br />SEOVE <br />FRS <br />,METAL FIREPLACE A CHIMNEY <br />RAINLEADLRS <br />DAR. ETC) <br />O <br />CI„ <br />SUBTOTAL <br />S <br />SUB TOTAL <br />PERMIT <br />PERMIT <br />S I <br />n <br />TOTAL FEE <br />S <br />TOTAL FEE <br />S <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />STREET SETBACK <br />RCAR YARV ST iBACK <br />FEE <br />RECEIPT NO. <br />LOT AREA <br />VACANT SIR <br />FEES VALUATION <br />IF❑YES <br />C N0 <br />JPANCY GROUP <br />OF STORIES <br />71 7 BE DR <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2 BUILDING PLANS <br />B FIRE HYDRANI <br />4. FIRE PROTECTION SYSTEM <br />5 GRADINGII%CAVAT ION B CLEARINGIGRUBBING <br />6 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />DISTRICT <br />UMBING <br />CHANICAL - <br />WIILTDNILDING ES <br />THER <br />UDC <br />NALTY SEC JUTIa)TALRMIT <br />VALIDATIONIZEN PROPERLY VALIDATED (IN THIS SPACFI THIS IS YOUR PERMIT <br />B HEALTH <br />.om vATION ACC BY PLANS CHECKED BY APPR FOR ISSUANCE NY <br />9-1.79 <br />