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.Yd <br /> �PPLICATION FOR cYe <br /> C'�YOFe,pe, CONSTI�UCTIOh � <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICE$ � <br /> CiTY HALL 259�6745 <br /> EVERFTT WA9B201 ��OMBIWATIOM UILDING ❑MECHANICAL ❑PLUMBING PERMIT NQ. <br /> blell nODN[SS CITY ZIP PHONE <br /> ow�Ea x,,.�.. � 9�0 � _ a•s-� � �;� <br /> ��>e, ��� , �,, � ,��,, a���� <br /> ,I�d/fyJ AIC�./A/YJIA9��h [ITY ZIP GHONE <br /> �RCMI1Kt OR O[S�GNI�—L MAII ADCRE55 n ( �y <br /> � � � � q�I�C '�/�1/���VUv _� <br /> [NF� COYiX�.CI � � <br /> MAII ADD�ES ❑TY ZIP PMONE UCENSE 1 <br /> � � ^ �" ' "- CIIY LIP PMONF IICENSE I <br /> AIiOIANIUI COYINACIOR MAII A�DRE55 <br /> ��tr ZIP PNONE LICENSE I <br /> pWM11111uLCOH�RAQ00. MeILAD�RE55 <br /> C1A55 OF K'OAK <br /> ❑NEW ❑ADDITION ❑A:TERATION ❑REPAIR .C�DEMOLITIOu ❑FENCE ❑SIGN � GARAGE CBUILDING RELOGTION <br /> W W Ai ION UI W O0.K <br /> S <br /> ❑[SCRIBF WORK <br /> � <br /> PPO�OSlDUSF Of PUIl01NG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A - <br /> x ��� � � � ��Q PUC�TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> iee�ia�scai Tor+ rrn �a.�ylsallo�xEiow �T������OIIRCOPIf51 OF WORK WILL DE COMPLIED WITH WHETHERSPEC�FIEDHEREIN <br /> �'I <br /> iot��_ei K o� OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> ^� �L�� �/ GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> / � ����( t'1/r / ANY OTHER STA7E OR LOCAL LAW REGULATING CONSTRUCTION <br /> � �a..76s �G""-- � OR THE PERFORMANCE OF CONSTRUCTION. <br /> � L SICNnTURE OF COv7NACTOR OR AUTMORIZED AGENT DATE <br /> �(/. /(o � �� � � /_/�/._. <br /> > ��i x�ooxas �� � h� � � � — � �''�'�� <br /> Gi�,, 1 � -�',��x.��� '�� � � <br /> PlUM81NG MECHANICAL � � <br /> NO. TYPE OF FIXTURE FEE <br /> NO. TYPE OF EQUIPMENT ��E <br /> AIR COND UNIfS—NP.EA <br /> WATER CLOSET QOLIET� REFRILERATION UNIiS—HP.EA <br /> OnTHTUB <br /> OOILERS—��P E� <br /> UVAiORY(WASH BASIN) <br /> GAS FIRED AC UNITS—TONNACE EA <br /> SHOWER <br /> fORCED nIR SYSTEMS—B T U M EA <br /> KITCHEN SINN 6 DISP <br /> —�— WALL HEATERS-0 T U. M <br /> DISwASHCR <br /> UNIi HEAiFRS—B T U. M <br /> LAUNDRYTRAV <br /> EVAPORnTIVE COOLERS <br /> CIOTHES WASHER CLOTMES ORYERS <br /> WAT[R MEATER yENTIUTION FAN <br /> � URINAL RANGE HOOD <br /> �RINKINC fOUNTAIN <br /> AIR HANDLING UNI7— C.F M <br /> � ROOR�RAIN <br /> STOVE <br /> VACUUM BREAKERS <br /> MfTAL fIREPI.ACE 6 CHIMNEY <br /> ROOF ORAINS—RAINLEADERS <br /> SINK�SERVICE—BAR.ETC 1 <br /> SUBTOTAL f <br /> SUB TOTAL PEpM�T S <br /> f <br /> PEIIMIT 7p7AL FEE s <br /> TOTAL FfE s <br /> PLAN CMECK FEE <br /> SIDF YARD SETOACK STRECT SCTOACK RCAR YARD SE10AIX �LAN CNCCK NUMBCR FEf H[CEIPT NO. <br /> USE ZONE LOT AREA VAC�NT SITE FFfS VALUATION FEE <br /> ❑Y[5 CNO <br /> jiYPE OF CONST OCCUPANCY GROUP NO OF DWELLING UNITS <br /> �UILDING 3 . <br /> � SIZE OF BL�G NO UF STORIES MA% OCC IOAD <br /> PLUM�ING <br /> FIRE ZONE BASEMENT fiLDROOM1IS REQUIREIDNKLERS MECNAr9UL <br /> (�YK C�NO <br /> � APPAOVALS !T DATE OTHER <br /> U.e C <br /> 1. ENVIRONMENTAL CHECK LSi pFNALTY SEC 1011a) <br /> 7 BUILDINC PlANS TOTAL <br /> 7 FIRE HYDNANT ' <br /> PFIIMIT'ULIDATICN <br /> � FlRE PkOTECTION SVSTEM �.;;��N PNU�f HlY bM ID�iI.D'W IIIIS SMCp THI515'.OUR FENMIT <br /> 5 GNADINGIF%UVATIONBCLkAFINGILRU9RINL <br /> 6 DRAINAGE - <br /> 7. ENVIRONMF�TAL IMPACT STA7EMENT <br />