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APP'L�CAl�i�1y FQR <br />�TM�`°`"� �ONS�RUCTION <br />everett PE�Rr11T <br />DEPT OF COMMUNITV DEVECOPMENT SERVICES <br />CITY HALL 259-8745 <br />:VERETT, WA 98201 �COMBINAT�ON ❑ BUILDING <br />�01YNlR M.�II AOOXI55 <br />, ii /s . _ ./.: / / <br />L ❑PLUMBING PERMIT NO. <br />ZIV PHONF <br />everett <br />e <br />�RCNRlCL 00. OLSIGNt0. M�II ADOXI55 ❑TY ' ZIF PHONE <br />�� � L[NIN.\l COrviReCIOF n:All ApDRESS CIiY ZIP PMONF IICENSE / <br /><�CUiY�= � <br />M[Cb�HIUL CONIt'�QOF MAIL �DOR6$ PTY 21P FNONE IICENSE / <br />PlUn1PIVG CONINARON MAII nDDFE55 Cliv LP PHOM1E IICEN$E / <br />[tA5 Uf N'ORN <br />�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOUTION <br />VAWAiIpNOf WORN <br />`.GSSf` df N'ORN / <br />.. /��/%��C,'�/ /:F'eo�CC� /��/2C/,� /� <br />. PeUfOSfU USf Of PUROiNG <br />�f'P.r��.1 <br />lECnl �FSCRIFtipv Of P0.UP[R�Y 6HOWN BEION' ON �Ti�CM IOUR COPIES� <br />ior mocK_or _ <br />�ln.i� ^µ�s � <br />G <br />PUJMBING <br />NoT— <br />f1ATHTU6 <br />UVATORV <br />SNOW[R <br />TYoE OF FIXTUNE <br />tlA51N� <br />DISWASMEN <br />UU�DNY TRAY <br />CL07H6 WASHER <br />WATER H[A7ER <br />URINnL <br />ORINKINC.FOUNTAIN <br />FLOOR DftAIN <br />VACUUM BHEAKERS <br />ROOFD4AIN5—RAINLEAOE <br />SINK 6[RVICE-9AR, ETCJ <br />YARD SE <br />SUBTOiAt <br />l0T AR[A <br />TYPE OF CONST � OCCUPANCY GROUP <br />SIZE OF <br />FIRE ZONf <br />A►PROVALS <br />1 ENVIRONMENTAL INCCK LIST <br />7. BUIIDING PlANS <br />7 FIRE MYDRANT <br />4 fIRE PROTECTION SYSTEAS <br />5 GRADI'�CIE%UVATIONAQkARINGf�NUtlNING <br />6 UR11N�G: <br />7. kNVIRONME�'T�� IMPICT STATEMENI <br />B. MFAUH DISTRIQ <br />�t <br />ftCAN YARD SETfiAIX <br />VAUNT SRE <br />❑YES ❑NO <br />NO CF DWfLLING UNITS <br />MA% OCC LJAD <br />(IRE SPR.INKLERS <br />NEt]UfRED <br />❑YES ❑NO <br />EY D�TE <br />APPI IGTION ACC 9Y PlANS CHECKED BY I �P7R. LON ISSUANCF BY <br />4-1-7Y <br />/ /YPF-'cd-S 3�7J O /NS�r�7/.�� <br />r ,l'1':^."pE�TI' .i/J� �i'il;-n':� fti,? -%�rSUF/�7'cP 1,�;�/�c+%ti5' , � <br />I HEREBY CfERTIFY THA'( I HKVE EAD AND E%AMINED THIS AP- <br />PLICATIO�: AND KI.OW �fHE SAME TO 6E TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEl2NING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SFECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOE$ NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THi PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE HfRFORMANCE OF CONSTRUCTION. „�� � ,}/ c <br />SILn�qTURE OF CONTRAGTOR OR �}1THOftIZED AGENT% � DATE /� �O� <br />� �� -� � , <br />MECMANIifL <br />NO. 7YPE OF EQUIPMENT FEE <br />AIR COND UHITS—H P EA <br />RfFRIGEHATION UNITS—H P EA <br />BOILERS-11 P EA <br />WS FlRE� AC UNITS—TONIiAGf EA <br />fORCED AIR SYSTEMS—B T U M EA <br />N'AlL HUTERS—�SL !A <br />UNITHEATERS—UTU M <br />EVAPORATIVE COOLERS <br />VENTILATION fAN <br />RANGEHOOD <br />AIR MANpLING UNIT— C.EM <br />STOVE <br />MfTAL FBEPLACE 8 CHIMNEY <br />TOTAI s <br />AIT S <br />iOTAI FEE s I .� � I'� � <br />CMiCK NVA10[R PLAN CHECK FF.E <br />FfE I RECEIPTNO. <br />VALUATION <br />9UIlDING S <br />YLUMBIhG <br />MECHANIGL <br />OTHER <br />PENALTY UD.C. <br />$EC. 107(a� <br />TOTAL <br />tfRM1T VALIDA410N <br />WHEV PROPERLY VAIIL`�TEL (!N THIS SPACEI TMI515 YOUR PERMIT <br />� <br />�J <br />