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�►-PPLICATION FUR- t�� <br /> �noro"'° .:ONSTRUCTi01� 0 <br /> ever�tt PERMIT <br /> DEPT OF COMMUNITY DEVELOPMENT SEPVICES <br /> CITY HALL 259-8745 <br /> EVERETT,WA982�1 ❑COMBINATI�DW C BUILDING ❑MECHANICAL ❑PLUMBING PE�RMIT N <br /> ��P �,3 � <br /> ownie M.n eoox�ss cnv ' ' � .- � <br /> - 5I"� G h ,..t - <br /> e :� C , � ; �,. . <br /> ARCM ICi 0.O[SIGhIR �NIl1DO0.F55 <br /> ntr nr vno�c <br /> `11Y Z�p PHOME llCfrvSF I <br /> LfNEReICONIReC10R .vnllnpDQ�SS <br /> �p�q�nlUL CONiRACtOR MAII�D00.E55 <br /> UiY CIV PMONE LICENSf I <br /> PIL'4�111�'G COHt0.AQOA M�IL eD�RF55 <br /> CItY ZiV PHOHf UCENSF I <br /> nnssutNoaK ❑SIGN ❑GARAGE ❑gUILDINGRELOCAiION <br /> ❑NE�'�' ❑�DDITIO� ❑�LTERATION ❑REPAIR ❑DEMOL�TION ❑FENCi <br /> Y�IU�I ION Of N'00.1( <br /> �5� o cC <br /> ClSCNiBf\VORK <br /> :�J G�i <br /> vxovosious�ov nmioi� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS nP- <br /> PLICATIC.�N AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> ��OVISIOPlS OF LAWS AND ORD:NANCES GOVERNING THIS TYPE <br /> l[GAIORCXIP110'�OIVROPt41Y�5NON'NBEIOM'ON�LiACHfOURWPI[51 S� WORKWi!.LBECOMPLIEDWIIHWHETiHERSPEC�FIEDHEREIN <br /> I�,+l!'�n oce�l�or 'h '�`'t-�f `E' � ��r��`ES OR NOT. THC (;RANTING OF A PERMIT DOES NOT PRESUME TO <br /> �°' GIVE AUTHORITY T? VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATUR CONTRACTOH OR AUiH00.1ZED AGENT DAiE <br /> IOP�DDF65 X /�Lf ' LG . ( ^ / � � _�j' � / <br /> � 0 -�c <br /> ME ANIUI <br /> PLUMBING TYPE OF EQUIPMENT FEE <br /> NO. TYPE OF FI%TUIIE <br /> FEE NO. <br /> AIH COND UNITS—N P E� <br /> WATERCLOSETITOUfT) REfRIGERAiIONUNITS—!iP fA <br /> yA7HiUB f1011ER5—HP kA <br /> ��yATORY I�YASM BASIN) GAS FlNED A C UNI75—TOiJNAGE EA <br /> SHQwER FORCED�IR SYSTEMS—B T U �A EA <br /> KITCHEN S�NK 6 OISP WALI MEATENS—BTU M <br /> OIS�v�SHER UNITHEATFftS-17TU M <br /> IAUN�RYTRAV EVAPOAnTIV[ COOLERS <br /> CL01M`-S W�SMEB ��pTHES DRYFRS <br /> WAT(R MF�TER V[NTILMI04 FAN <br /> URINAL RANGE HOOD <br /> DRINKING FOUNTAIN AIR HANDLING UNIT— C.F M <br /> FIOOR DRAIN S70VE <br /> VACUUM 9REAKERS M[lAl FlRfPLACE 6 CHIMNEY <br /> RO��ORAINS—GAINIfADFRS <br /> SINK(SERVICE—BAN,FTC 1 <br /> SUl70TAl f <br /> SUt TOTAL �ERMIT s <br /> � ���'N�T s TO1Al iFE s <br /> TOTAL fEE f PLA4 CHEIX FFE <br /> SIOF YARD i[TD��K STRLET 5!T�ACK R[AR YAR�SfT9ACK PLAN CMCCA NUh1B[R 'FE RKEI�T NO. <br /> �pT AREA yACANT$ITE VALUA710N FE[ <br /> USF 20NE FffS <br /> ❑YES ❑NO <br /> NO OF DWELLING UM�7S <br /> TYPE OF CONST OCCUPANCY GROUP s <br /> euiioir+c <br /> 9ZE OF OL�G NO OF STORIFS MA% OCC LO�D �� <br /> PWAI�ING <br /> FI0.[ ZONf B�SfMENT OLDflOOMS ft�C��REIDKLE0.S ME�H�NIUL <br /> C]YES C7N0 <br /> A��IIOVALS /t OATE OTHEN <br /> U.B C. <br /> 1 ENVIRONMEN7AL CNECK L15T PENnLTY SEG J011a) <br /> 3 BUIIDING PUNS TO7Al <br /> 7 FIRE NYDftANT <br /> ��'—��" �ERMIT VALIOAiION <br /> .1 FlRE PROTECTION SYST[M WHFN PpOPERLY VALIDATFD IIN TMIS SPA:FI THIS IS YOUN PFRMIT <br /> 5 GRADINLIfXUVAT�ON6QfARINGIGNUBBING <br /> 6 ORA!NALE � <br /> ) ENVIRONMENTALIMPAQ STAT[MENT <br /> E MEALTH DISTNICT <br /> �pp���A7�pN��[ BY PLANS CHFCNED bY APPR FOR ISSUANCF BY <br /> g.1 79 <br />