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APf'LICAT9()N FOh <br />~�ONSTRUCTIOf� � eV� <br />everett.�- � PERMIT . <br />nEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />Ci�Y HA',L 259-8745 <br />EV[RET1�. WA98201 �COMBINATION L� BUILDING ❑MECHANICAL ❑PWMBING PERMIT NO. <br />OIYNER M�ILAODNE55 [�iy ].IP PMONF <br />1Gh _v-c� �/�(o�d '1�111- �-oWer I'�idce ZI d. CvereN, Wu. 982a1 �53-�S�h <br />ARCIIIIfCiUNOE5IG\LN MAIIAU�NE55 CIIY 21P� vqn�'. <br />GfNENAI CJuiR,1CTOR MML AODRE55 UTY ZIP PHOnE llCkrvSE p <br />F_vere oY131oµ -ru �i/�,b��REEvevc�reeN tifa,� Evave:�-1 WN198ao3 353E91�1 o"�3EQIp�V- <br />FR-EB-��i PFF <br />PLUAIPING CONTRACiON , MAIL ADDHE55 CiY 21P PIIONE LICENSE p <br />QA55 OF 1YORY. <br />❑NEW ❑ADDIIION <br />VALUATION OF \"02K <br />S algb.00 <br />o�cscame woaK <br />'\aoF y-� � <br />^aoroseo use or nunoiHe <br />/ _. <br />�ALTERATION ❑REPAIR ❑DEP�OLITION ❑FENCE ❑S�GN ❑GARAGE ❑6UILDING RELOCATION <br />ws <br />l[GAL 06CRIPTION Oi PROPCRTY �SM01VN OfIOW OR ATTACN fOUR IOPIES� <br />�or macK_or <br />'�px # 39�,0- <br />loo nooREss <br />�,�Ill- l,ov.(e <br />PLUMBING <br />NO. <br />WATCR CLOS <br />TYPE OF FIXTURE <br />FT (TOLICT) <br />IAVATOP.V (1YASH DASIN) <br />SHOWER <br />KRCHEN SINK 6 DISP. <br />DIS\V�SFIEP. <br />LAUNDRVTRAY <br />CLOTHES WnSHER <br />1VATER IiEATER <br />URINAL <br />�RIhKING iOUNTAIN <br />fLOOR DRAIN <br />VACUUn10REAKERS <br />ROOP �RAINS—RAINLEAI <br />SINK (SERVICE—IInR. ETC <br />USE ZONE <br />TYPE OF CONST. <br />SIZE OF E7LDG. <br />FIRE ZONE <br />SUBTOTAL <br />PEAMIT <br />TOTALI'.E <br />S7RFET SeTf71 CK <br />LCT qgEA <br />OCCVPANCY GROUP <br />APPRO\'ALS <br />L ENVIHONMENTAL CHCIX L15T <br />7. �UILDING PLANS <br />1 FIR[ HVDRANT <br />4. FlRF PROTKTION'iYSTEM <br />5 GHADINGII%CAVATIONACLkAHING�GRU0111KG <br />6. URAINAGE <br />Z ENVIRONMENTALIMPACTSTAi[MENT <br />B. HEALTH DISTRICT <br />�� <br />FEE <br />�f <br />REAH YARD SETOAC <br />VAGNT SRE <br />�YES ❑NO <br />NO.OF nWELLING 1 <br />MAX. OCC LOAD <br />FINE SPRINKLFHS <br />ftEQUIftFU <br />ilYfl [7N0 <br />BY DAiE <br />APPLICATION ACC. HV PIANS CHFCKFD Ol' I APPR. hOR ISSUAN�F. 17V <br />`"` � � <br />9-1 79 <br />I HEREBY CERTIFY TH�T I HAVE READ AND EXAMINED THIS .1P- <br />PL�CATION AND KNOVJ THE SAME TO BE TRUE nND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNIt�IG THIS TYPE <br />OF WORK WILL �E COMPLIED WITH WHETNER SPEC:'=IED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER S�fATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PE[j(j FORMA�NCE OF CONSTRUCTION. <br />SIGNA7URE.VA'CONTRA{,ityRORAUTHORIZEDAGENT _DATE <br />�� <br />AECHANICAL '' <br />NO. TYPE OF EQUIPMENT <br />AIR COND. UNITS—H.P. EA <br />REFRIGFNATION UNITS—H.P. EA <br />IiOILEftS—H.P. EA <br />GAS FIR[D A.C. UNlii—TONNAGE EA <br />FONCCDAIRSYSTEMS-13T.U. h' <br />WALL HCAT[HS—O.LU. M <br />UNITHfATERS—ISTL. M <br />EVAPORATNECOOIERS <br />VFNTILA�ION FAN <br />RANGEf100� <br />AIR HANDLINf, UNIT— CEM. <br />AtC1AL FlREPLACE & CHIMN[Y <br />i <br />FEES <br />SUB70TAL 5 <br />PERMIT S <br />FEE <br />FEE <br />iEE S � <br />PLAN CHECK FEE <br />RECEIPT NO. <br />VALUATION FEE <br />11UILOING 5 q/T l ` <br />o/ ( V i� <br />PWMOING <br />MkCHANIUL <br />O7HER <br />PFNALTY U-0.C. <br />SEC. SO7�a) <br />TOTAL <br />� <br />PERMIT VAIIDATION <br />WHEN PROPFRLY VALIDATED pN THIS SPACE� THIS IS YCI IR PERMIT <br />