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AP,I�LICATION FOR ,� . e�e,�„ <br /> everett C`� NPERMITTION ' e <br /> DEPT. Of COMh�UNITY DEVELOPMENT SERVICES <br /> CITY HALL 259�8745 <br /> EVERETT, WA98201 �COMBINATION ❑ BUILDtNG �MECHANICAL ❑PLUMBING PERMIT NO. <br /> owN[n naunoo�css arv zir rr�oN[ � <br /> �—��2 S�uCfr� lC:t�7 L��n� �.�.,� �CJr���ff 4 S�2-�I ��/�`� �`� <br /> ANCHR(CT OR�[$IGNER �1 IL A�ORES$ CITY ZIP P��ONE <br />' i <br /> G[NFRALCONiftACTOR MAILAO�RE55 CITY ZIP PHON[ LICENSEN , <br /> n1[CHANIUICONTRACTOR MAILADDftE55 CITY 21P PHONC IICENSEM , <br /> �lan�� <br /> P�L61111NC CONTHAQUft A:AII ADORf55 UiY Zif' PHONE UCENSE p �. <br /> CLnSS Oi WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SICN ❑GAR�GE ❑dUILDING RELOCATION <br /> VALCATIOu Of WORA '�. <br /> S <br /> 06CRIB[\4'ORK / I� ' <br /> rxo�osmuseoroui�owc I HERE6Y CERTIFY THAT I Hl,VE READ AND EXAMWED THIS AP- ! <br /> PLICATION ,1ND KNOW THE SAME TO BE TRUE AND CORRECT ALL � <br /> lEG,1LDESf.RIPilO40FPHOPERiY15H0\VNpfl01VON�TTACHFOURCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF`NORK WILL �E COMPLIED WITH WHETHEfi SPECIFIED HEREIN � <br /> ior n�o�K_o� _ OR NOT. THE GRANTING OF h PERMIT DOES NOT PRESUME TO � <br /> GIVE AUTHORITY TO VIOLhTE OR CANCEL THE PROVISIONS OF �. <br /> AN` UTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OP. TH[ PERFORM.4NCE OF CONSTRUCTION. <br /> SIC'JATURE OF CONTRAQOR OR AUTHORIZED ACENT DATE <br /> ����ES`7 LrSml-a�r-c� � �e_r�tl- qk�bl �;��-�-�— � /-�Ra <br /> PLUMBING MECMANIfqL � <br /> NO. TYPE OF FIXTURE � FF.E NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET ROLIET) AIR COND Ui\'ITS—H.P.EA <br /> RATHTUB R[FRIGERr�iION UNITS—H.P.EA <br /> l.4VATORY(WASH BASIN) UOILtRS—H.P.EA <br /> SHOWEH CA$FlHED A.C.UNITS—IONNAGE EA <br /> KIiCHEN SINK&DISP. PORCFU AIR SYST[M$-07.U. M EA <br /> DIS\YASHER �vALL HEAfERS—U.i.U. �t <br /> LAUNDRV TRAY UNR NEATFNS-11T.U. M <br /> CLOTHES\YASHER EVnPORATNE COOLERS <br /> WATER MEATER CLOTHES DRYERS <br /> � � URINAL �'fNTILATION fAN <br /> DHINKINGFOUNTAIN RANCEHOOU <br /> FLOOR DRAIN AIR HANDLING UNR— CFM. <br /> VACUUM BREAKEftS STOVF <br /> . ROOF DNAIN$—RAINIEADERS � M11fTAl FlREPLACE 8 CHIIdNEY OO <br /> SINK(SFRVICE—UAR.:-iC) <br /> SUB TOTAL SUB TOTAL S OD <br /> PERMIT S PfRM1T y '� p� <br /> TOTAL FEE f TOTAL FEE S OD <br /> SIDE tARD SETOACK STREET Si1UACK REAR YARD SETIlACK PLTN CHECK NUMIIER PLAN CHEC1: FEE <br /> FEE RKEIPT NO. <br /> � ) U�E ZUNE LOT AHEA VACANT AT[ FEES VALUATION FEE � <br /> ❑YES ❑NO <br /> 'YPE OP CONST OCCUPANCY GROUP NO.OF DWELIINC UNRS <br /> f7NLDING b <br /> 52E OF d1.DG. NO.OF STORIES MA%.OCC LOAD <br /> PLUMPING <br /> FIRF ZONE 6A5[A1ENT OLDROOM$ RRE SI'RINKLFRS <br /> ftEQUIRED MFCHANIUL Od <br /> r1YF5 ❑NO <br /> APPROVALS BY DATE OTliFR <br /> 1. [NVIRONMENTAL CIiECK LIST PENALTY �'�'�' <br /> SEC 307�a) <br /> 2. EIUILDING PLAN$ <br /> iOTAL �7 � <br /> 3. FlRE HYDRANT / <br /> 4 FlRE PROTKTION SYSTEM PERMIT VpLIDATION <br /> �y�{[N PFOP[ftLY VALIDATED(IN iH15 SPPCE)THIS IS VOUR PERMIT <br /> 5 GRADING/f%G\VATIONBCLFAHWG�CHU1111MG <br /> G �RAINAGE <br /> 7. kNVBpNMFNTA1.141PACT5TATEMENT <br /> b. HEALTH DISTNICT <br /> ,11`I'I IC,\il�lti \t�C P.1� Pi\Vti f IIICRI J Ilti :\I'PK IOk ISSV�\NCI 111 <br />