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,�.E�.,D�,� APPLICAT�ON FOR everett <br />°�TM°F CONSTRUCTIOn e, <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259�8745 <br />EVEREii,wn9e:ot ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />ON'NlH M�II eDDH65 CITY ZIP PHON[ <br />S�sTs ��d �fA��rw'u� goS �O�cG. rnn.��sr� 'C�r�". <br />nRC11RECtOXOFSICt�IR AInIIAOOft[55 Cliv ZIP PHONf <br />LLN[RAL CON1P�Qp0. nNIL ADDRE51 CRV TIP PHON[ LICEuSE � <br />��«..cv S�G�..1 �'• �c G$ �. �8a.a4, 2S�-oo�y4 ��.Mc-csr c2�xAi <br />A1ICHANIUL CONiRAC�OR MAIL �OOPE55 CIIY 11P PNONE IICENSC X <br />PWMpWCCONiNACiOR M�IIADDNfSS CIiY ZIP PHONF <br />CUSS Of N'OXK <br />❑NE\v ❑ADDITION ❑ALTERATION ❑ftEPAIR ❑DEh10LITION �FENCE �IGN ❑GARAGE ❑BUILDING RELOCATION <br />�����r�o, o� �vaae <br />Jy�oa�i <br />o�s'�LY�'1"TAL��k] ��.�121L <br />raovosiovst or xunoinc <br />LECAI UfSCBIPiION Of PROPE0.LT IS��O\VN 9[lUN' OR AtI�CH fOUN COPIF51 <br />ioi _ oiocn_o� <br />�ON <br />PlUM01NG <br />N�O. TYPE OF FIX7URE <br />1 1vA1ER CIOSET �TOLIfT� <br />UVATORY 1�1'ASM BASIN) <br />KRCMEN SINK 8 DISP <br />DISw�SH[ft <br />IAUHDRYTNAY <br />CLOTHES WASNER <br />\VATER HEATER <br />DftINK14G FOUNTAIN <br />FLOOH ORAIN <br />VACUUM 17REAK[RS <br />ROOF DRAINS—RAINLEADLRS <br />SINK 6EHVICE—BAH. ETC� <br />SIDE YnRD SCTf7AIX <br />USE ZONE <br />TYYE OF CONST <br />SIZF OF BLDG <br />fBC ZONL <br />FEE <br />SUB TOTAI <br />PERMIT S <br />TOTAL FEF S <br />2FET SETOAIX 8UR YARD SFTpACK <br />LOT AREA <br />OCCUPANCVGROUP <br />�'O OF STORIES <br />pASEMENT BLDNOO�VS <br />APPROVAlS <br />1. ENVIRONMENTAL CHKK 115T <br />2 BUILOIPti PLArvS <br />7 FlHF H'OHANT <br />J FB[ PROTKTION SYFEM <br />5 GRADINGIkXU\'ATIONbCIURINGIGftUN111NG <br />6 DRAINAGE <br />7. ENVIRONMENTAIIMPACTSTATEMENT <br />B MEALTH OISTRICT <br />APPLICATION ACC. BV PLANS CHECKED UY <br />9.7-:9 <br />VAUN T S I l E <br />C]YES CNO <br />NO Of D"[LLING l <br />MAX OCC LOAD <br />FIHE SPftINKlkNS <br />NEQUIRED <br />!IYfS ❑NO <br />BY DATE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO �E TRUE AND CORRECT ALL <br />PRO'JISIONS OF LA�VS AND ORDINANCES GOVERNING TH�S TYPE <br />Of NWORK WILL �E COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR hOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />G�VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />�NY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUBE OF C9NTRACTOR OR AUTHOHIZED AGENT DATE <br />: / b <br />X ,.. ��'a""..�"<' .. 7 � Z. � l �/ �'-- . <br />�—i— <br />MECHANICAL <br />NO. 7YPE OF EQUIPMEN7 FEE <br />AIHCOND UNI7S—HP EA <br />REfBIG[RATIO� UNITS—H.P EA <br />IIOILE85—MP !A <br />GAS lIRE� A C. UNITS—TONNAOE EA <br />lOftCED AIH SVAEMS—[i.TL M EA <br />WAIL MCATERS—II T V. M <br />UNIT NUTERS—B 7 U M <br />t\'APORATNE COOlERS <br />V[NiIUTION FAN <br />NANGEHOOD <br />AIH MANOLING UNIT— <br />SiOVE <br />M[TAL FIREPUCE 8 CI <br />SUBTOTAL S <br />PERMIT S <br />iOTAL FEE s <br />CMCCK NUn18ER PLAN �HECK FEE <br />FEE I RECFIPT NO. <br />VAlUAT10N <br />BV:_DING s����' <br />PLUh101NG <br />MECHANIUI <br />OTMER <br />PENALTY U.6.C. <br />SEC 30J(a� <br />iOTAL I I � <br />PENMIT VALIDAiION <br />WHEN PftOPERLY VALIDATED (IN TMIS SPACE� THIS IS YOUR PERMIT <br />��li� �� �����,� <br />O� `T �24'�kj�� <br />.«,.._.�..�.,. ....,, ._._:. . _. '..; _.. . . . : . ... . _ . . . <br />_, <br />