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A�PLI�ATION F�OR <br />��-�� ``�ONSTRUCTIC)N'� <br />everett._: - ��Rn��T <br />DEPT, OF COn1MUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-87��5 <br />EVERETT, Wn 9P:01 ��OMBINATION ❑ BUILDING <br />OIVM1F R MAIL AD[lNf SS <br />��ch�ard Inlold '1H11-l.ower i'?,dc� <br />ARCH <br />❑MECHANICAL ❑PIUMBING PERMIT NO. <br />CIiY ZII' 1'HONE <br />IZd. CvereH, Wu. 98aoI �53-�8'�h <br />everett <br />� <br />rt[CIOHO[SIGNFH bURADOR[55 n�T ZIP PNONE <br />L[N[NALCOrvTNAC10H M�IIAD�ef35 Clil' ZII' PNONE llC[RS[.1 <br />Everel} 13�dvs. Tuc. �pf�-Ever�r�N �nfa�� Cveve.�-l. Wr�. q8ao3 �3�3-�11�1 �73-0l-�V- <br />MkClIANIGL CONIR�CIOR MAIL AUURE55 CI1V l.IP PHONE .�,^_ _ llCf��l �, 1 <br />t/� �[j rr <br />PLUAItlING CONiNACTOR . MAIL AODHE55 CITV ZIP PHONE IICENSE p <br />ll�)� OF \' ORK <br />❑NEW ❑ADDITION <br />W lUAiION OF N'ORK <br />s alffb.oa <br />OFSCRIpE N'OftK <br />1'�0o F �i- 1n(i <br />raorasen us[ or uuunine <br />ALTERATION ❑REPNR ❑DEMOLITION ❑FENCE ❑S�GN ❑GARAGE ❑I3UILDING RELOCATION <br />Ndows <br />L[GAl D6CRIPiION OF PNOi'FRtY ISIIOWN �tL011' OR ATLnCH FOUH COPIES� <br />LOi OIUCK_Of <br />'�px#3aaa-ocb -oai-o3o3 <br />ioo nooaas <br />n N I 1- l,o V�(2v T�'tdn e!Z' c�. EJereti ��� �w <br />PWMB�NG <br />NO. TYPE OF FIX7URE FEE <br />WAiER CLOSET (fOLIET) <br />fIATHTU� <br />LAVATORV I�VA551 OASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />DIS\VASIIER <br />LAUNDRYTRAV <br />CLOTHES K'ASMER <br />\YATER HEATER <br />URINA� <br />DRINKING FOUNTAIN <br />fLOOR DRAIN <br />VACUUM1I�6EAKERS <br />ROOF DRAINS—RAINLEADERS <br />SID[ <br />TVPE <br />I <br />SUB TOTAL <br />PERMIT S <br />TOTAL FEE S <br />iEET SETf1ACK Rk <br />LOT AREA <br />APPROVALS <br />i. ENVIRONMfNiALCHkIX 115T <br />7. UUILDING PL.WS <br />1 FIRF HYDRANT <br />4 FlRt PROTFRION S�STFAt <br />GNOUP <br />I IiEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT qLL <br />PROVIS�ONS OF LAWS AND ORDINANC[S GOVERNING THIS TYP[ <br />OF WORK WILL 6E COMPLIED WITH WHETHER SP[CIFIED HEREIN <br />OR NOT. THE GRANTING OF A PER��11T DOES NOT PRESUME i0 <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PE FORM��NCE OF CONSTRUCTION. <br />51GNAiURE�CONTRA�LIryRONAUTHORIZEDAGFNT „DATE <br />NO. � TYPE OF <br />AIR COND. UNITS—H. <br />YARD StT13ACK � PLAN <br />NLINIGtNAIION UNITS—H.P. EA <br />BORERS—HP. EA <br />GAS FIRED A.0 UNITS—TONNAGE EA <br />FORCED AIR SVSTEMS—RT.U. N <br />WALLHEATERS—ES.TI� M <br />UNR HEnTERS—O.T.U. M <br />kVnPONATNE COOlERS <br />VENTILM ION FAN <br />RANGEHOOO <br />AIR IIANDLING UNIT— <br />METAL FlREPLACE & <br />VACnNT SRE {EES <br />❑YES ❑NO <br />�O. OF DWELIING UNIiS <br />MA% OCC LOAD <br />FlRI SI'NINKLFRS <br />R[QUIRfD <br />flYf'S I�NO <br />BY DA7E <br />SUB TOTAL 5 <br />PERh11T f <br />TOTAL FEE S <br />f1UILDING <br />PLUMUING � <br />MECHANIGL <br />OTHFR <br />Pl NALTY <br />TOTAL <br />PIItA1R l'AlIDATI04 <br />—_ . . ..., . J ."I.l� .. <br />FEE <br />b <br />unc <br />5[C.J03(a) <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />FEE <br />