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fhsEraipres�� A�PLI�ATION FOR ���,�„ <br />��^�°F -� CONSTRUCTIOh �1 <br />everett PERMf'i' <br />D[Pi Of COMMUNITY DFVELOPMENT SERVICES <br />CITY f{��� 259�8745 <br />EVEttEtT.wn5e70t ��QMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIR MAIIAUUNf55 CRY ZIP PtlONI <br />ji1;c.�r,e.� L• .SiUnioN 73 A l_Uw�i` Pi�nn Rp �ileiefl" ifiav3 3s �- 9s'�U <br />AqC.11ilClO0.U[SIGNSR MAIIAO�P[55 CI�Y ZIP VNON[ <br />SG�m4 Oe Q.G-w2. <br />YG�N�0.�LCOM�A�C�OP MAllAOUP[55 CIIY 21P VIION[ IICENSEI <br />ybt:�ae/ L. .$faN,�f'oN �3o6 `owcr y��c�gr Rd. Gucr��t 96'3u3 3s_a-eyyv <br />n11f��AniUICOMRKIOR M�II�DU^F55 f11Y LP PNO`�E liCWSEI <br />P�Un�01wGCOn�R�UOR MAIL�ODF[55 CIIY Z�P VNONF UC[NSF� <br />[tA5! Uf WORK <br />❑�CW �ADD�110N ❑ALTERATION ❑REPAIR ❑DEMOLIT�ON ❑FENCE ❑SIGN ❑GARA(:F ❑BUILDINGREIOCATION <br />vn�uRtioN or woaK V <br />� i�T,4 _ 2E�Oe0.0 <br />nucaim woAK <br />rabrosto ust or n7uJimwc n <br />itcei�i�cairio�raortntr�s��o Hn[iow <br />�� flIDCK _ O�� <br />� %�� <br />IOP nUUR(SS <br />PLUMB�NG <br />NO. 7YPE OF F�%TURE <br />y� WATENCLUSET�IOLIE71 <br />k OATHIUB <br />LAVAIORY �WA511 PASIN� <br />S��OWER <br />KIICIiEN SINK 8 UISP <br />OISWASM[R <br />UUNUNY iRAV <br />URINAL <br />URINK�NG FOUN7AIN <br />FLOOR ORAIN <br />VACUUM PREAK[RS <br />ROOF DRAINS—RAINLEAU <br />SINK 6ERVICE—lIAR. FTC 1 <br />SIUF YARn 5I7'IACK <br />�� <br />USf ZONE <br />�— �L <br />TYP[ OF CONSt. <br />� N <br />SiZE Of BLOG <br />A�oN I2�G s•; <br />FI0.E ZONF <br />SUE TO1AL <br />fEE <br />lOi AREA <br />OCCUPANCYCROUP <br />fZ 3 <br />NO.OF STORIES <br />2 <br />OASFMENT IIkUROOMS <br />— 2 N�uJ <br />AVPIIOVALS <br />1 FNVIFONMENTAL CHFCK LIST <br />7 OUILDING PlANS <br />7 RRF HYORANT <br />1 RRE PNOI[CTIDh SYSTEM <br />5 GHADINLIL%CAVATION6ClEAR�NWGRUtl01NG <br />6 DAAINAGE <br />) fNVIRONMfNTALIMPACTSTATEMFNi <br />E HFALIH OISTRICT <br />APPLICA(ION ACC. BY <br />�, �3. <br />9�7�79 <br />COPILSI <br />[u N . <br />I HEREOY (.ER71FY THAT I HAVE READ AND ERAMINED THIS AP- <br />PLICATION AND KNOW THE S,4ME TO OE TRUE AND CORRECT ALL <br />PkiOVIStOh i OF LAWS AND ORDINANCES GOVERNING THIS TYNE <br />OF bVJRK NRL 6E COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOL Tli:�. GHANTING OF A FFRMIT DOES NOT PRESUM[ iC <br />GIVE AUTHORITY TO VIOLATE OR CANGEL THE PROVISIONS �1F <br />�NY OTfiER STA7E OR LOC�L L!.'N REGULATING CONSiRUCT10N <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAIURE OF CONiRAQOR OR AUTHOP.IZEO AGFNT DATE <br />x /�lc..�.�,.f% „� ,�fi.......�. � �r 7�� Z. <br />MECHANICAL <br />FEE NO. TYPE OF EQU <br />[`�J AIR CONU UNIT$—fl P. EA <br />/L O NEFRIGERATION UNIT$—H <br />, ( 1701LERS—HP EA <br />YARUSElOACK � PLAN <br />VA[ANT 51 <br />❑YE$ O <br />NO.OF DWEIU <br />I <br />MA%. OCC. l0/ <br />!Y I DATE <br />CAS FIREU A.0 UNI75—TONNACE EA <br />FORCEDAIRSYSTEM$—�.T.0 h <br />wALL HEA7ER5—O.T.U. M <br />UNIT IIEA7CR5-0 T U. M <br />FVAPORAINE COOLERS <br />CLOIHFS DRVENS <br />VFNTIUTION PAN <br />RANGfHOOD <br />AIR HANULING UNIT— C F M. <br />MEUL FIREPLACE d CHIMNEY <br />L <br />FEES <br />SUB TOTAL <br />f <br />tOtAtfEE s� <br />PLAN CII[CK F[E <br />FtE � �3 , pCCEiPi NO. <br />FEE <br />o���o�N� ' 2vF� a� / 8 <br />rwn+ou+c <br />MFCHANIGL <br />OSIiEA <br />PfNALTY U.00. <br />SEC 70J(a) <br />T�T�� / 7 3 L <br />PFIIMIf VALIDATION <br />WNEN PROPERLY VALIDA7ED IIN Tk115 SPACE� TMIS IS YOUN PERMIT <br />7 rjj'. ��% !��/E O,t-/ �L.bi�! G'/J --C'c,� <br />PLANS CHECKED BY APPR �OR ISS�JANCE BY ' "'� • <br />-i�ts)'�1 � . C , <br />