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APPLICATION F(�R ��«<n <br /> th�EwrprNn Cp N ST R U C�I O , . � <br /> qtt OF <br /> everett . PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES • <br /> CITY HALL 259�8745 <br /> EVERETT,WA98201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMITN <br /> oyvHw <br /> M�II�DOH65 CIIY Z�P P���E <br /> U G.�r � U��-�t� <br /> � ��/'� MeIL�RE55 M�/� ❑Tr ZIP PNONE <br /> A0.CHIT[CL ON OESILNFR <br /> G[N[R�lCOrv10.A[lOR 'nAILADDR[55 <br /> CItY ZIP PHONE LICENSE 11 <br /> n�f CHANIUI COVTRn[IOR <br /> M�IL�ODRF55 CI1Y LIP PHOME IICENSEtl <br /> PlL!'�1NtiGCONiXAQOR N.AIIADORE55 <br /> ❑IY ZIP PMONE LICFNSEI <br /> c❑NEW,oRK❑ADDITION ALTERATION ❑REPAIR ❑DEMOUTION ❑FENCE ❑SIGN ❑GARAGE ❑OUILDING RELOGTION <br /> VAlUn110N Oft,V�itN <br /> � ��D <br /> OfSCRIpF N' RN � <br /> �,`�r ��-st ��,- ��,r,��r�,N s � �� <br /> raur eouse qr xu ioi�e I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> ����y�� PLICATION AND KNOW THE SAME TO OE TRUE AND CORRECT ALL <br /> ��x' pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> IEG�I 0lSCRIPiIOY O!PROPFRiY 15110\VN 9ElON'OR�IUCH iOUP COPI6) OF WORK W�LL BE COMPLIED WITH WHETHER$PECIFIED HEREI.'! <br /> ioi _awcK__o� OR NOT. THE GRPNTING OF A PERMIT DOES NOT PRESUME TO <br /> �YE7TFIEROSTATE Ok LIOCAL L W EGULATING CONSTRUOCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> S�GNAT E OF CONTRACTOR OR AUTHORIZED AGENT 3�T�� �/ <br /> � 11 J,�� .-,( , .,_ <br /> ioxnooaess�OO,� / � /�h lL�.[(�ill�>� <br /> �-o J <br /> MEfHANICAL <br /> PLUMBING FEE <br /> FEE NO. TYPE OF EQUIPMENT _ <br /> Np, TYPE OF FIXTURE �le COND UNITS-H P.kn <br /> WATEH CLOSET�TOLIET) <br /> REFRICERATION UNITS-NP. EA <br /> BATHTUB <br /> �OILERS-M P EA <br /> LAVATOkYlWASH BASIN� <br /> GAS FIftED A.0 UNITS-t�NNAGE EA <br /> SNOw[R <br /> fCRCE�AIR5Y5TEM5-BTU MEA <br /> KITCfiEN SINK E DISP <br /> µ���� HEATERS-81.0 M <br /> DISWASHER <br /> UNIT MEATEHS-8 i U M <br /> LAUNDRYTRAY <br /> EVAPORATIVE COOlERS <br /> CLOiHFS wASHFR CLOTHES DHVERS <br /> WATER NUTER <br /> VCNTILAiION FAN <br /> LIRINAL <br /> RANGEMOOD <br /> ORINKING FOUNTAIN <br /> FLOOR�RI.IN AIR HANDLINC UNIT— C.F M u � <br /> STOVE " i '—. <br /> VACUUM OREANERS <br /> MLUL FlFEPUCE d CHIMNEY <br /> ROOF DRAINS—RAINIEADERS <br /> SINK ISERVICE—�AR.f TC 1 <br /> SU!iOTAL f � 5� <br /> SUBTOTAL pEI1MlT f � ^t" <br /> PERMIT S 3 .i� <br /> TOTAL FFE <br /> TOTAI FEE s <br /> p��N CHECK FEE <br /> SIOE YARO SETItACK STBEET iRf1ACK RUR YARD SETI7ACK PLnN CH[CK NUMBER FEE PEiEIPT NO. <br /> U5: 7.ONE LOT AREA VACANT SITE FEES VALUATION iEE <br /> OYES GNO <br /> TYPE OF CONST OCCU�ANCY GROUP NO OF DWELLING UNITS <br /> �UILDING s <br /> SIZE OF �LDG NO OF STORIES MA% OCC IOAD <br /> PWMBING <br /> FIREZONF BASEMENT flfUNO"/M5 REQUIREIONKlE0.5 MKMANIUL <br /> OYfS ❑NO <br /> APIAOVALS OY U�iF OTHER <br /> 1 ENVIkONMENUI CHECK LIST PEH��Ty U.BC. <br /> SK JO)(a) <br /> 2 BUILDINL PUNS 7piAL <br /> 7 I'IRE MYDkANi <br /> ►ERMIT VAIIDATION <br /> 1 FlRE PR0IECTIqN 5Y5TEM WHEN P0.0PfRLV VAIIDATEDIIN THIS SP�CF)THIS IS YOUR PENMIT <br /> 5 GRADINCL%GVATIONb�LtARINGGNUBNINC <br /> 6 DRAINAGE <br /> 7. ENVIRONMENTAL IMPACT 1T•:tEMENT <br /> E HEALIH DISTRIIT <br /> APPLICAiION ACC 9Y PlANS CMECKfD BY APPR FOR ISSU�NCE BY <br /> v �-- <br /> 9 1-79 <br />