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,,,.Ewro,„� ,�4 PP L��AT I O N FO R ���,�„ <br /> °�TM°F I,JNSTRUCTION �i <br /> everett PE RM IT <br /> DEP;. OF COMMUI�ITY DEVELOPMENT SERVICES <br /> CITY HALL I59�8745 <br /> EVERETT,WA 90201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMSING PERMIT NO. <br /> �NfR� k�� ��� ���I�DDk�S/ // ����'`�� ZIP PHOvf <br /> eRCMIIECL 00.061GN1R MAIL eUONl55 ❑iY ZIV PMONF <br /> LENFRAI CONLfX CIOR�/ MAIL AOURE55 �CIsiY— 21P YHONF IKENSE/ <br /> ��f'�Ce G�-�.� .e��rs 53�5 5/?9� ���c-r� 9�v� s'S5 .�9J-�D��/jA��NA�,�oinh <br /> nRCN� IUl CO`�LpACiOR L e0D0.F55 UTY LIP PMON[ / IICENSf I <br /> PIUmNIhC CONi0.ACiOX mAll nDDRE55 CIIY ZIP VNONE UCENSE 1 <br /> [U55 Of wONR <br /> ❑NEW ❑ADUITION ❑ALTERATION �REPAIR ❑nEMOLiTION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> / <br /> \'nWAT10'�Of WORR <br /> S ���� <br /> OISCRiB[wORK <br /> _/ ' � <br /> % <br /> raoroscousF or nmiou+c � I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS AP- <br /> PLICATIOh AND KNOW THE SAME TO 8E TRUE AND CORRECT ALL <br /> LEGnt�[SCRIPLIONOi PXOPFRIY�SHOWN OFLOW ON AtTACH{OUR COPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> '� ''• �' OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> iot�eiocK��� or __�� �`'•'�' OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> :i �i GIVE AUTNORITY TO VIOLATE OR CANCEL THE PPOVISIONS OF <br /> �/ ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRL�CTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. � n <br /> loe nDoa[55 SIGNAIURE OF CONTRACTOR OR AUTHORIZED AGENT DATE �—J�+ — �U <br /> X � � <br /> PLUMBING ` MECHANiI'AL <br /> NO. TYPE OF FIXTURE FEE NO. TT�E OF EQUI�MENT FEE <br /> WATER CLOSET(TOUET� AIR COND UNITS—HP.EA <br /> BATMTUB ' REFRICERAiION UNI75—MP EA <br /> . lAJA70RY�WA$HBASIN� BOILERS—NP EA � <br /> SHOWER CA$RRED A.0 UNITS—TONNAGE EA <br /> KI7CHEN$INK 8 DISP FORCED AIR SYSTEM$—B.T U. M FA <br /> DISWASHfR WALLHEATEBS—B.T.0 M <br /> UUNOkY THAY UNIT HFATERS—B.T U M <br /> CIOTHES WASHE0. EVAPCRATIVE COOLERS <br /> WATER HEATER CLOTMES DRYERS <br /> URINAI VFNTILATION FAN <br /> ORINKING FO�INTAIN NANLF MOOD <br /> FLOON �RAIN AIR HANDLINC UNIT— C.EM. <br /> VACUUM BREAKfRS STOVf <br /> ROOF DRAINS—NAINLEADERS ME7AL fINFPUCE 8 CHIMNEY <br /> SINK 6ERVICE—BAN.ETC� <br /> SU�TOTAI SU�70TA1 � <br /> rEIIMIT f ►ElMIT f <br /> TOTAIFfF f TOSALFEE � <br /> SIDE VAHD SLiBACK STRfFT SCTBACK RUR YAHD SCTOACK VIAN CMECK NUMbER PLAN CHE[K FEE <br /> FEE RECEIPT NO. <br /> USf ZONE LOT AREA y�CANT SITE <br /> ❑YES ❑NO fEFS VALUATION iiE <br /> TYPE Of CONSi OCCUPANf.Y CROUP NO.OF�WELLINC UNITS <br /> a���o�N� S 3a 60 <br /> SRE OF ALDG. NO OF$TORIES MA% OQ IOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT 17kDROOMS FIRf SPRINKLE0.5 <br /> REQUIRFD MECMANIUL <br /> ❑YES ❑NO <br /> A�►�OVAl3 �� DATE OTMER <br /> L ENVIRONMENUL CHECK LiST U.B.C. <br /> PENALTY SEC.JO.�a� <br /> 1. BUIIOING PtANS — <br /> ) FIRE MYDRANT TOTAL 3a d <br /> 4 FIRE PROTECTION SYSTfM ►EIIMIT VAl10AilON <br /> -� WHEN P0.0PfRLY VALIDATED pN TMIS SPACE)THIS IS VOUR PfBM1T <br /> 5 LRADINGIkXGVATIONBCLfARINGIG0.UBBING <br /> 6 DRAINACE <br /> Z ENVIRONMENTALIMPAQ STATEMENT <br /> E. HEALTM DI[f0.1CT <br /> APPLICAl10N ACC. BY PLANS CMECKED 9Y APPR FOR ISSUANCE PV <br /> 9-1-79 <br />