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r <br /> i <br /> �naE�e�9,aa� 4 PP L I CA T I O N FO R <br />' °""°F CONSTRUCTIOf� everett <br />' �verett e <br /> DEPT OF COMMUNITV DE\'ELOPMENT SERVICES PE R� �T <br /> CI1Y HALL 259�8745 <br /> EVERETT, KA 9A201 �COMBINATION <br /> �.. — BUILDING ❑MECHANICAL ❑p�UMBING PERMIT NO <br /> O �q <br /> Il DO [5 <br /> 1bA,C�li[,� d�76�1.[� R,C4uc�Jres i " •�P -- <br /> v��or+E <br /> ��z ��M,sr,�,en • ��c,�i�- .R y�z�� as9 a93�- <br /> aourEctaao�sc iu ui ouaFss � « <br /> I �e�F ��r� r��� — <br /> r��oNE <br /> GIIVIN�I[ONIRAQOH n1AllApDRtSS <br /> S e/� , ❑iV I.IP FHONF <br /> � (�� �,S 4 i� iicEnsc r <br /> �+ic�+�nicnic . rxnciox � G ��� J ���/uC/!c/J ,S ' G li� <br /> MAII ADORE55 UtY <br /> t�P PHONE tICENSE/ <br /> PI VM(11AL CUNIHAUGH AIAIL�OOXI55 ' <br /> ❑t1 ZIV <br /> PI�O�'+F lt[EHSE I <br /> QAR Oi IiONK},-5' <br />�. �hE�v ,LIADOITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE <br /> ❑SIGN ❑CAftAGE ❑E3UILDING RELOCATION <br />� A'AWAilOupi 1yORK <br /> ' 3ot� n� „� �Pss <br /> UIfCH101 NOX6 <br />� /�,01J Gc /o � Ki3� APc,� /n ifemr� Cu//h �^G�%inf o� .�.f'�.oCS� �S>e�r a., v�eSipP . <br /> Y»TNc NPis�f n��1��.f�s 6 � <br /> ruoiostousi oi xwioiv� <br /> ��.�p�.nG� I HEREUY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> I PLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT ALL <br />. uui ot�cviPuovor vaov[arr�s�wwrv x[iowoa eir��H rouumriEs� PROVISIONS OF LAWS ANU ORDINANCES GOVERNING THIS 7YPE <br />� _xiocK_ov OF WORK WILL 6E COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ioi <br /> OR NOT. THE GRANTING OF A PERMIT DOES NOT pRESUME TO <br /> S�� �7 � 6S GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANy OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION <br /> ,iL�(�� / / , OR THE PERFORhtANCE OF CONSTRUCTION. p p <br /> — ��CC HC' / � SIGNATUHC OF CONiRACTOR OR AUTHORIZED AGFNT DATE�–p –p.�� <br /> IUII nL�I!SS <br /> //Z6 ca,�zg� v • - �.�, X . <br /> ewMeiNe <br /> ,/�. <br /> ME ANICAL <br /> NO. 7YPE OF FIXTURE FEE NO. <br /> WqifH CLOS[T(TOIIETI TYPE OF EQUIPMENT FEE <br /> IIAiHTUO AIN CONp Un175–H P FA <br /> BEFRIGERATION UNIiS–HP EA <br /> UVATORY�WASN flASIN) <br /> 5110\Vt N <br /> ROIIERS–HP EA <br /> GA$FlNED A C UNITS–TONhqCC EA <br /> KI7CHFN SINK B DISP <br /> � fORCEDTIR$YSTCMS-BiU MEA <br /> UISIYASHlR <br /> \VALLHfAT[N$-BTU ht <br /> IAUM1DNI'TRAY <br /> UNI7HU71H5-[ITU M1t <br /> CL07Mt5 VVASHER U'APOHqTNF COOLFHS <br /> \YA7ER HUTCR <br /> URINAL <br /> CLO7HFS DRYIRS <br /> DRINKING FOUN7AIN ���T��AT�ON fAN <br /> FLOOR �RAIN H�NGF HOOD <br /> AIN HANpLING UNIT- C F h1 <br /> l'ACUUM IiRUKEftS <br /> ROOf DRAIhS-gAINLEADENS $IOVE <br /> 61ETAL FIREPUCF 8 CHIMNFY <br /> $INK�SERVICf-17AR,E TC� <br /> SUB TOTAL <br /> PENMIT SUB TOTAL S <br /> S <br /> TOTAL fEE PEBMIT y <br /> S <br /> SIDI vAND 51TIfACK STRF[T SC7MCK TOTAL FEE S <br /> H�AH �ARD StTIUCR PUN CH[CA hUMtlEft PIAN CHECK FEE <br /> USE ZON[ LOT AHfA D /(���-sl �k� Oro RKEIPT NO <br /> VAUNT$IIE � ✓���–� <br /> ❑Yfi ❑Mp fFCS VAWATION FEE <br /> iYPE Of CON57 OCCUI'ANCYGROUP h0 p� OW(LIIN(;UNIIS <br /> �'- N aco�n�N - r�s � <br /> SIZF OF IfLOC NO OF STORIES IIUIL[]IN� y�M, �, <br /> MA% OCC IOAU <br /> 130 S.f;DPG+: I "�� /U a,J <br /> -- PIUMUIN(; <br /> FlNL ZONE UAS[MENT plpkUUh�t flNt SPNINKLfRS <br /> — � NfQUIRfD MfCMANIUL <br /> � ` �IYFS (Rdp <br /> APVNOVAlS BY DATE <br /> OTIItH <br /> 1 fNVIHONM[NTAL CHE(K LIST <br /> 2. OUILOINCPUNS PtNAIiY UPC. <br /> SFC 3U)�a� <br /> 7 lIRE HYDBANi TOTAL <br /> � Rkf PNOTLCTION SYSiEM <br /> /U � <br /> PEqMiT VAIIDAiION <br /> S GHAUING4%UVnTIONb Cl1ANINGGHUHIIING WHlN PROPfRLY VALIDAiEU�1N iH15 SPACE�i111S 6 VOUk PERMIT � <br /> I <br /> 6 DRAINACE <br /> 7 ENVIRONMENULIMPACTS7ATEMENT <br /> B HEALTH OISTRICi <br /> APPLIUTION ACC BY PLANS CMECKLD BY Appft FOR ISSUANCE HY <br /> `'.� - L- <br /> , � <br /> ` i11 <br /> 94 79 <br />