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�, <br /> ,�.Ewro,,,� ApPLICATION FOR ���,�„ <br /> °�TM°F �ONST�UCTION e <br /> everett PERMIT <br /> DEPT OF COMMUNITY DEVEIOPMENT SERVICES <br /> C�TY HALL 259-8745 <br /> EVERETT,WA 98201 �]COMBINATION ❑ B�:ILDING ❑MECHANICAL PLUMBING PERMIT NO. <br /> OWNfR M�II AO�NESS UTY ZIP PIIONE <br /> �,'r�crS/1'�. 1�v�z� ��z Q�� D�n�� �� �3 3.s.�3�89 <br /> ANCHR[�T OR OFSIG4EN MAII ADDRf55 CIiY 21P VHONE <br /> GENERAI CONIPACtOP MAII AOORE55 ULY ZIP PHON[ IICErvSE/ <br /> M[CHAtiIUt CONTRACiOR MAII A000.ES$ CI1Y LIP PHONE IICFNSE I <br /> PIUn101uLfONTR•.Ct.,.. MAlle00XF55 ULY ZIP PHONF VCENSEI <br /> [1n550f NORK � <br /> ❑NEW ❑ADDIiION ❑ALTERATION EPAIR ❑DEAIOLITION ❑FENCE ❑SICN ❑GARAGE ❑BUILDING RELOCATION <br /> vuu�noa or woaK <br /> ' �PFOCHc� XoT$`C°40/.�fFr�R LINES UP TD I1'1�4�N LlN� <br /> OLSC0.IBF wORN <br /> �OLA� U�ATE�2 LiNES <br /> vaovoseouu or nunoi�ue I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �/rqL PUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> IELAI OE5[RiPilOY O!VROPFRiY15HONN 9llOW OR�i1�CN fOUR COFIF51 PROVISION$OF LAW$AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ioi eioca_or . OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> — q /�, OR THE PERFORMANCE OF CONSTRUCTION <br /> �O� / (�+mB9�20 SIGNATURE OF CONTRACTOR OF AUTHOR�ZED ACENT OATE <br /> IONnUDR[55 G / ... /'"l,� <br /> X � Z //7 / C�/��� <br /> PLUMBING ANIGL <br /> NO. TYPE UF FI%TURE FEE NO. TY►E OF EQUI�MENT FEE <br /> WATER CIOSET(TOLIET) ��R COM1� UNIT$—N P. EA <br /> fAiHiUC REfRIGERATION UNITS—M.P.FA <br /> UVAiORV IWASH BASIN� 1701LEN5—N Y kA <br /> SMOwfR GAS FIRED AC.UNITS—TONNAGE EA <br /> KITCHEN SINK 8 DISP FORCED AIR$YSTEM$—B T U M EA <br /> DISWASMER WAILHEATERS—BTU M <br /> IAUNDRYiRAY UNIIMEATFHS-9TU M <br /> CLOTHES\VASMER EVAPORATIVE COOlERS <br /> 1VAiER MCATER CIOTHES DRYERS <br /> URINAL VENIIUTION FAN <br /> ORINKINCfOUNiAIN RANCf MOOD <br /> FLOOR�RAIN AIR HANOLING UNIT— C.F M. <br /> VANUM BREAKERS STOVE <br /> NOOF ORAINS—RAINIEADERS METAI FBEPUCE d CMIMNEY <br /> SINK 6E ICE—B .ETC) <br /> � ' O <br /> Sli!TOTAL � O SU�TOTAI f <br /> �ELLMIT 3 O �ERMIT f <br /> TOTAIFEE f ' QQ TOiALiFE s <br /> SIDE YARD SFTO,�CK STNEFT SCTl7ACK RUR YABD SETOACK PLAN CHECA NUhIBER PIAN CMECK FFE <br /> FEE RECEIPT NO. <br /> USF ZONF LOi ARFA y�[�NT SITE <br /> GYES CNO FEFS VAWATION fFE <br /> iYP[ OF CONST OCCUPANCY GFOUP NO Of DWELLING UNITS <br /> 9UILDING s <br /> SIZE OF BLDG NO OF$TORIE$ MA% OCC LOA� <br /> PWMBING S�O <br /> FlR[ ZOvE O�SEMENT flkDNOOMS RfQU REIDKLERS MFCHAMGL <br /> ❑Yf5 ❑NO <br /> A��ROVALS �Y DATE OTNFR <br /> 1 ENVIRONM[NTAL CHFCK LI51 pENALTV U 9C <br /> SfC lOJfa� <br /> 2 �UILD�NG PUNS I <br /> J RRF HYDkAni tOUI � <br /> C fBE P0.0TECTION SYSTEM �EIIMIT VALIDATION <br /> WMEN PROPERLY VALI��TEO iIN iN15 SPACC17H6 6 YOVR ,�'RN�IT <br /> 5 GRAnING'f%CAVA710NbQEARING/GRUNNINC <br /> b DHAINAGE <br /> 7 FNVIftONMENTAIIMPACTS7A7FMEN1 <br /> . .��u il� f111I1'i'I _ <br />