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.,'�w!,PLICATION FOR ._� ���,�„ <br /> '".E".,°"'" L�NSTRUCTION e <br /> cm oF <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALI 259�0745 <br /> EVERETT,WA 98201 �COMBINATION ❑ BUILDING ❑MECHANI�AL ❑PLUMUING PERMIT NO. <br /> pWNl0. MM1II ADONRS Cli1 LC PHONF <br /> r/v�-TTS r�a�n� I?a� ta�.,rsnnn BJrr a,r4 98� 7 s2- .?1G� -- <br /> ARCHItI�1 OR�[SIG'�!R MAII ApDRE55 CIiY ZIP PNONE <br /> MAII A000.E55 CILY ZIP VNONE li[FNSE� <br /> ccr+txnimv�a�croa .fN`c,�. T- $K <br /> �dRRY n.�aa,.� :.p Z�.Jc 2 �0 � GI°� � � YN ` �N 4¢�oe � 7�G S$3 � scf.. /JCRnYr'��0, <br /> p1ICNANIUI CONiRACiOF <br /> Mn�l AOD0.E55 CIiY 21Y PMONf LICENS[I <br /> !'IUNpWG CONiR�CiOX <br /> Wnil eDOP65 U1V 21P FHONE UCENSE/ <br /> ❑ASS Of N'ONK <br /> C�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE SIGN ❑GARAGE ❑BUILDING RFLOCATION <br /> YAWAiIONOf WONK � . �J�'7 <br /> �' � // i, <br /> S 3000 �" � <br /> I]ISCRIIII \YOMN <br /> �K..RL�t1' d' I+�N-.D^� � <br /> 2 �X12 N�N ST6N Le'� �o✓"'��� <br /> P0.0PO;tD�Sf OI nmmivc I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THI$ AP• <br /> OW�,.�r1 �iL C S/4'�— PLICATION AIvD Y,NOW THE SAME TO 8E TRUE AND CORRECT ALL <br /> ueei o�seaiPno�o� rRovexn�sr�owN euowou enncn roca covies� PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THK TYPE <br /> OF WCRK WILL BP. COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ior aioc�__or OR NOT. THE GR�NTING OF A PERMIT DOES NqT PRESUME TO <br /> GIVE nUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> AN1' OTHER STATE OR LOCAL lAW REGULATING CONSTRUCI ION <br /> OR THE PERFORMANCE OF CONSTRUCTION. � <br /> SIGNAiURE OF CONTftACTOR OR AUTMORRED AGENT DATE <br /> �od���ok�55 X � ��,_,_,. ( — 2s—`6 J <br /> /327 o c..14- ' <br /> hLUMBfNG MECHA�CAL _ <br /> NO. TYPE OF FI%TURE <br /> IEE NO. TYI'E OF EQUIPMENT FEf <br /> v.'ATCR C105lT�TOUEiI AIk COND UNIIi-M P EA <br /> REFRIGERATION UNITS-NP. EA <br /> MTHTUB <br /> IAVATORY IW�SH PASIN) E10RER5-��P EA <br /> GAS FIkED AC U�+ITS-TONNAGE EA <br /> SHO\YFR <br /> fORCFD nIR SYSTEMS-B T U M EA <br /> KRCHEN SINK h f)ISP <br /> WnLIHEATfNS-BiU M <br /> DISWASHER <br /> UNIiHEATERS-B'U M <br /> UUNDNY TRAV <br /> CIUTMES W�SHift EVAPORATIVI COOLERS <br /> WATFR HEATER CLOTHFS DRYFGS <br /> '"'- \'ENTItATION FAN <br /> UftINAL <br /> DRINKING�OUNTAIN RnNGE MGOD _ _ <br /> �11;IIAKUL:�.G Uv1T- C F M <br /> FIOOR DkA1N ---� <br /> VACUUM BREAKEftS �T�V� --- <br /> AOOF DFAINS-NAINLEADFRS METAI FlNEPUCE 8 CHIMNEV <br /> SINK�SERVICE-BAR ETC 1 � <br /> SUlTOTAL s <br /> SUE TOTAI <br /> PERMIT S PFIIMIT f <br /> TOTAIiEE s <br /> TOiAI FEE s <br /> PLAN CMECK FEE <br /> Siqf 1�T'.0 SRB�CK STRECT SCTOACK HUR YARD SE70ACK PUN CHECK NUMHER RECEIPT NO. <br /> FEE <br /> l��i l.G��'F LOT AREA y�UNT SITE FEES VALUATION iFE <br /> OVES ❑NO <br /> TYPE OF CONST OCCUPANCY GROUP NO OG DWELIING UNIiS <br /> BUILOING f �E�' '�U C Z �() <br /> SRE OF OI�G NO.OF STORIES MAX OCC IOAD <br /> PLUM[IING <br /> FIftE .iONE 9ASEMENT I7tDROOMS REQUIREDKlERS MECHANI[AL <br /> CYES ❑Nn <br /> A�7ROVALS !Y DA7E OTtIER <br /> 1 FNVIRO`1MENTAI CHECK 115T pENAITY U.BC. <br /> SEC )03(al <br /> I. BUILDING PU>15 �Z a� <br /> TOTAL <br /> J FIRE HYDRANT <br /> � FIRE PROIECIICN SYSTF�.1 �fI1M1T VAIIDATION <br /> WMEN PROPERLY VALICATFD ON THIS SPACE)TMIS 151'OUR PENMIi <br /> s cH�oihc�[r.cnvnrior+ncicnr.ir+acaueniNc ��SL � ���� TQ �E ,lyLLl� O.�! <br /> 6 DftA1NAGE tl �p�/ <br /> 7 ENVIftONMENTAL IMPACT STATEMENT / .QIUQ� P���G'"�� <br /> 9 MEALTH DISTRICT }/�'�J d <br /> � � APPLICATION ACC BY NS E1 � nPPR fOR ISSUANQ tlY �^^� �� �( �(G'G� <br /> �a:� i /; <br /> _ -- �� , _ �.�=� � <br /> 9.1-79 <br />