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T' <br />� <br />Me Evergreen .A_ P P L I C A T 1 i�� ��iV F O R everett <br />:�ry�F - �ONSTRI;�TiON e <br />�verett • PERM1� <br />DEPT OF COMMUNITY Df\'ELOPMENT SERV�CES <br />CITY H�,�L 259-8745 <br />eveReii,wn�eio� �COMBINAISON ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. ��_oop.�"' <br />Owl:tR Mnll �OOxE55 • CIiT ZIP VHUNE <br />c i.�� C"�c)�orn 5/o M4�+so.t C�er.etf 98zo3 353 - 89-9c�1 � <br />ARCIIIifCLOR [SIGN(R M1�AILAODR[55 CITY Z�i' PNON[ <br />GINfR�lCON1RAC�OR mnil.eD�XFSS CITv ZIP VHONE LIQNSEM <br />ML[HnNi:�l CONtHACipR MAII AD�N[55 ❑iY GIP pMONE IICENSE I <br />PIUf�NmG�ON�RACiOR MAIInODRF55 CIII 21P PIIONF IICFNS[I <br />Cl.�SS OV V�OXK <br />❑NRv �ADDI710N . ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOUTION <br />\'A W �l IUN Of \tiONK <br />� i z�o \/ i� <br />otsck�u[ woxr: <br />Ae�l �+ lo„el bed�o��,�_, � . .. <br />rxaPouo usr or nunmyc r <br />/O /�vE ivi �l'�ouse ci6��`�iov <br />llGnl OF SCHIPI lO�. Of PROPf RLY �SMO\VN BElO�� OH AiTAU1 f OUR CC <br />lGl � IILOIX � Of <br />ion ��oa�ss <br />=/v Ma�ison �ue <br />PWMBING <br />NO. TYPE OF FI%TURE <br />� 1YATEHfLO°iETITOIIETI <br />fl�TM7U8 <br />SNOWER <br />DIS\5'ASM(R <br />CLOIM[SIVASMEH <br />\YA1fR MEATEH <br />URINAL <br />DRINKMG fOUNTAIN <br />I IOON DHAIN <br />VACUUM AHEAKERS <br />ROOf �NAINS—RAINLEADERS <br />SIrvK IS[NVICE—fIAR, ETC I <br />TOTAL FEE <br />SIOf YAR� SlTIinCK <br />USf ZONE I LOT <br />�G- 1 l�.�;o'�' <br />VPF OFCONST OCCUPANCY GROUP <br />�-i� /,Pv'�� K� <br />IZE OF BLOG NO. Oi GiORIES <br />FINE ZONE I tlAStMtNT I If[UHUU <br />APPqOVALS <br />1. ENVINONMENTAL [HECK LIST <br />2. tll11LDING PLANS <br />? FIRF MYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5 GRADINGIt%CAVATIONbCIE�RINWGRUtlflING <br />6 DRAINACE <br />Z ENVIRONMENTAL IMPACT STATfMENT <br />8 HEALTH DISTRICT <br />APPLIUTION ACC. BY PUNS CHECKED BY <br />� �(� �-ur-��� <br />9-1 %9 <br />I HEREBY CERTIFY THAT 1 HAVE READ'AND EXAMINED THIS AP- <br />PLICP.TION AND KNOW TtiE SAME TO 6E TRUE AND CORRECT ALL <br />PROVISION$ OF LA�Y$ AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL 6E COMPLIED WITH WHETHER SPECIFIED H"eREIN <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 STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGYAIUHE OF CONTRACTOR OR AUTHORIZED AGENT OATE <br />v Jti�n._.., �i1�„Dn„ il�1Y�Sv <br />MECHANICAL � <br />NO. 7YPE OF EQUIPMI <br />nIR COND UMTS—M P. EA <br />HEFRIGERATION UNITS—MP. EA <br />GAS FIRED AC U`11T5—TONNAGE EA <br />FOftCE� AIR SYSiEA15—Il T U M EA <br />\VALL MkATEHS—[7 T U. M <br />EVAPORATNECOOlERS <br />RANGENOOO <br />AIR MANDLING UNIT— C f ht <br />STOVE <br />METAL FlREPUCE A CMIMNEY <br />S tCJ <br />RCAR YANO SETOACK PUN <br />VACA�� <br />�VES fiNO <br />NO Of DWLLLING UNITS <br />I f1UILDING <br />occ iono <br />'— PWMBING <br />C <br />PEItMIT S � <br />iOTAI FEF S <br />NUntllf8 PUN CHECK ffE <br />FEE �� RECEIPTNO. <br />'/a �'.� � 6' ' l�of�/i <br />FEES � VALUATIOH fi <br />3 �—. ..._ _ C"C� . <br />IkQUBFD MFCMANIUL <br />lYFS (!�IVO <br />BY DATE OTMER <br />PENALTY • <br />TOTAI <br />APPR. FOR ISSUANCE HY <br />Ci � <br />U. B C. <br />SEC. 303(a) <br />PERMIT VAIIDATION <br />\VMEN PkOPERLY VAIIDATED (IN THIS SPACF) TIIIS IS YOUR PERMIT <br />% <br />L/J� <br />