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- , <br /> ,�,E�,o�,� _ A P�LI CAT I O N FO R �-- ���,�n <br /> ��TM�F �,�fVSTRUCTION e <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY H�LL 25}8745 <br /> EVERETT,WA98201 �COMBINA710N � BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNIR MMl�00X65 CItY ZIP ^i'ONE <br /> V 2���,-=�-�-,o' <br /> �au F /)'la�{so�� 7g ��f i.u�L, hurr� r ere`� �19�.01 <br /> ARCHRlCT R pF51GN[R MAIL�DDRE55 CITY ZIP PHONE <br /> GENER�ICONIPACiOR ./ MAII�ODRES$ UiY ZIP PHONE LICENSE�C <br /> Co�� ��1�s7�i�bc�o� Z'2.U9 7is S� ��2rn=� 932d5 33�! 8b9 i2orm � <br /> MFCNnHIUI CONiR�CiOR MAIt AOONF55 ❑1Y LIP PHONE IICENSf I <br /> PIUMBKG COHTRAft00. M�II nD�RESS CIIY ZIP PHONE IICENSF I <br /> � <br /> CU55 Oi 1vORK <br /> ❑NEW ❑ADDITION ❑ALTERATION �REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> l'1LU�LICN Of WORK <br /> f �� <br /> DESIRIPE WORM � <br /> e rof o �o.,� ��c�, � <br /> rxovosto ust ov awioi�c 1 HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LEGeI DESCRIVTIOn Oi YROPFRIY�SHOWN BFIOw'OR ei1�CH fOURCOPIE51 PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br /> a1J-�Z 3 IuSb�t .� � ,F�� OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> io� eiocK_ tor OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> ' GIVE AUTHORIT7 TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONiRACTOR OR AUTHORIZED AGFNT DATE <br /> IOB�DU0.[55 v / �i /�.- � /�/Q <br /> 9� a ar� � 6 <br /> PWMBING MECHANICAL <br /> NO. TY►E Of FI%TURE FEE NO. TY►E OF EQUI�MENT FEE <br /> WATER CLOSFT ROIIET� AIR COND UNITS—H.B FA <br /> RATMTUB REfNIGE0.ATION UNITS—H.P.EA <br /> UVATORY�WASH 9ASIN) 601LfR5—HP EA � <br /> ,� $HOWER GASFlREOAC UNITS—TONNACEEA <br /> KRCHEN SINK 8 DISP iO3CFD AIR SYSTEM$-9.T U. M EA <br /> DISWASHFN wALLMEATERS—B.TU. M <br /> LAUNORY TRAY UNIT HEATfHS—d T.0 M <br /> i <br /> CLOTHES wA5ME0. EVAPORATIVE COOLERS <br /> WATER MFATER CLOTHES ORVER$ <br /> I URINAL VENTIIATION FAN <br /> � DRINKINGFOUNTAIN RANGE HOOD <br /> � { f1.00R ONAIN AIR HANDLINL UNIT— C.F M. <br /> VACUUM BREAKERS $TOVE <br /> FOOF ORAINS—RAINLEADERS MFT�L FIREPLACE 6 CHIMNEV <br /> SINK($EHVICE—BAR.ETC) <br /> ' SU�70TA1 SU�TOTAL s <br /> ►ERMIT f ►EIIMIT f <br /> TOTAL FEE f TOTAL FEF S <br /> SIDF vARO SfT9ACK STRFEi SCTBAG: REnR YARD SETBACK PLAN fHECK NUM9E8 PLAN CMECK FEF <br /> � FEE I 0.ECEIPT NO. <br /> t <br /> �j USE ZONE LOi AREA VACANT SITE <br /> �VES ❑NO iEES VALUA7�ON iEE <br /> i <br /> TVPE OF CONST OCCUP�NCY GROUP NO.OF DWFILING UNIT$ <br /> 9UIlOING S i7�:� , ; — <br /> � SIZE Oi BLDG NO.OF STORIF$ MA% OCC LOAD <br /> PLUMOING <br /> i <br /> FIRE 20Nf BASEMENT 17l�NOUMS REQU REIDNKlfRS MFCMANIUI <br /> i L7YE5 ❑NO <br /> � �Y DATF OTMER <br /> A►�IIOVAl3 <br /> � 1 ENVIROYMENTAL CHkCK LIST pENAUY U.BC. <br /> SEC lOd(a) <br /> 2. BUILDING PUN$ <br /> J FIRE HYDRANT iOTAL j <br /> � FIHE PROTECTION SVSiEM ►fRMIT VALIDATION <br /> WMEN PR07ERLY VALIOATED(IN TMIS SPACE)iM15 IS YOUR PERMIT <br /> 5 GNADINGIk%GVATI0�+6CLkARINCICRUBNINC <br /> 6 DRAINAGF ! <br /> 7. ENVIRONMENTALIMPACTSTATEMENT <br /> E. MEMTH DI5T0.1Ci <br /> APPtIUTION�CC 9Y PI.ANS CHECK[D BY APPR FOR ISSU�NCE AY <br />