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Me Evergreen A p P L 1 C A.'T I O N �O R everetl <br /> °�TM°F �Q�NSTRUCTION � <br /> everett Pf,: RM IT <br /> DEPT OF GOMMUNITY DEVELUPIdENT SERVICES <br /> CIlY HALL 259-8745 <br /> EVERETT, VvA 90201 �COMOINATION ❑ BUILDING ❑ CHANICAL ❑PLUMBING PERMIT NO. <br /> o,�i�� � ��-7— l�r� i�����1/ .��1� , `��-�i��'�T 1�1/,� P..� ������z <br /> �RCM11lCi OR D( CVFR ���1 AODR155 CIiY IP �HONE <br /> G(NERAtCOMRACiOR MAIIApDRESS CIiY ZIF PHONE IICFNSEY <br /> I.IFCH�u1Ul WYIRACiON M11Alt AOOX[$ CI1Y 21P PNONf IICENS[I <br /> 19UMI11\G C06INACiOR M�II AOUX65 ❑iY 11P PIIONf UCENSE� . <br /> CUSS Of N�OVK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR DEh10LITION ❑FENCE ❑SICN ❑GARAGE ❑BUILDING RELOCATION <br /> V�WAiIOti pi NONK <br /> 1 <br /> ❑ISCNIIff N ' /A e — — <br /> / r <br /> aoros ui�st oi i um�: I HER[8Y CERTIfY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �(�� PUCAI ION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> iecni oiscuivrio�oi vuor�nir�s��ow �miowox niuu�ro coviE PROVISIQNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> .��� OF WORK WILL UE COMPLIEC WITH WHETHER SPECIFIED HEREIN <br /> ioi �_mocK,��Lof OR NOT THE GRANTING OF A PERMIT UOE$ NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER S7ATE OR LOC�L LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE Oi CONTRACTOR OR�UTlIOHIZED GFNT DATF <br /> IOB,1pUN[55 � � r � (% <br /> V <br /> PLUMBIN MECHANICAL <br /> NO. 7YPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE <br /> Y.'nTFN QOSf i�iOLEiI AIR COND UNITS—H P FA <br /> IlATMTUO NkfRICf eA710N UNI75—M P EA <br /> LnVATORY(\VASMf1A51N� f101L[RS—HP FA <br /> SHOWFN GASFlNLDAC UNI75—TONNAGEEA <br /> I;RQIEN SINK 8 OISP FOHCEU AIH SYSTEM$—B T U M EA <br /> p15\vASMEN 14AL1 MLATENS—17 T U M <br /> UUUCftY 7ftAY UNIi MtAifRS-11 T U hl <br /> CLO7Ht5\vASNFR F\'.\PORAiIVE COOLERS <br /> N'nif N HEATEH CLOTHFS DRYFRS <br /> URII:AI VENIIUiION FAN <br /> [)NIhKINC VOUNIAIN RANG[ HOOD <br /> f IOOH DRAIN AIK MANULING UNIT— C F M <br /> VANUAI IiREAKEHS STOVF <br /> HOOF ONAINS—RAINLEADEH$ �'.IfTAI FlNEVUCE 8 CHIMNFY <br /> SINK�5(R\9C1—HAR EIC) <br /> SUB TOTAL SUB70TAl S <br /> PENMIT S PERMIT f <br /> TOTAL FEF S TOTAL FEE s <br /> $IOF YAND SITpACK $TNEFT SLiMCK R[AN YAND SkTtlACK PLA4 CMECK KUMOER PUN CHKK FEE <br /> FkE RKEIPT NO. <br /> USE ZONk LOi AREA VAUNI Slil <br /> ❑YFS �_.NO FEFS �ALUA710N FFf <br /> iYPF Of COnST OCCUPANCY CNOUP NO Of DWFLLIN(;UNIiS <br /> OWLUmG S <br /> SIZF OF HLOC NO OF 57'ORIES MA% OCC faAU <br /> t <br /> PWMFlING <br /> FlNEZOti[ UASEMENT IIIUNOUN� HNISVNINKIENl <br /> NfQUINED MlCMAh9UL � <br /> f7YfS ❑NO �J <br /> �PPROVAlS 9Y DATE OiMER <br /> 1 ENVIRONMLNIALCHECKl157 U.BC <br /> PFNAITY $FC ]U31a� <br /> 2 IlUIlO1NG PUNS <br /> 3 fINE HYDRANi TOTAI <br /> i FIHI PNO7kCTION SYFEM PERMIT VALIDATION <br /> wMFN PROPERLY VAIIDATE�(IM1 7HIS SFACEI TMIS IS YOUR PEftMIT <br /> . 5 GNAUWG'kXUVATIONbCItARINGGRUHHING <br /> '� 6 URAINACi <br /> 7 ENVIHON61lNiALIMPACiSTATEMENT <br /> 8 M[ALTHD6iRICT <br /> API'11U110N ACC 6Y PUNS CHECKFD dY APPR FOR ISSUANCt HY <br /> q.i q�� <br />