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Me Evergreen A P P L d C A T I O N FOR fYlFCIT <br />CITY OF CONSTRUCTION e <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 <br />EVERETT. WA9S2o1 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />❑NEWG ❑ADDITION JaALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />\K Yl Of WORK <br />f <br />011 R1 YOR/K`' <br />PROP/Ey� ��/0 ii 01 BURDING j <br />1 - O 1 e yC- r-f / <br />IIGM DISCRIP71ON OF PROPERTY IsHowwosipw OR ttec uR mvR sl <br />%� O 4 y`, <br />LOf _BLOCK Of <br />YLY-• riif vry <br />T✓G5� +A1''/J ,I� �' t.x i ®O�T/-3 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME. TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECP9ED 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 STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTIQN. <br />SIGNATUR CO 1 L OR AUTHORIZED 7 DATE <br />X I - <br />I'm Ann R <br />-�j O �Q D <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />11 <br />W STIR CLOSE T ITOLIFTI <br />�� <br />AIR COND UNITS -HP EA <br />BATHTUB <br />REFRIGERATION UNITS -HP EA <br />_ <br />1 AVATORY (WASH BASIN) <br />ROILERS-H P EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />KITCHLN SINK A DISP <br />FORCED AIR SYSTEMS -BTU M EA <br />_- <br />DISWASHER <br />WALL HEATERS-B T U M <br />LAUNDRY TRAY <br />UNITHEATERS-BTU M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYk:S - <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />Q <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M -_ <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS -RAINLE ADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE -BAR. tic) / <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />$ <br />PERMIT f <br />70TAL FEE <br />sl <br />TOTAL fit f <br />SIDE YARD SI tHACK <br />ti/ <br />STREET S[T�ACK <br />/ /J �S <br />��T RJ <br />REAR YARDS HACK <br />��� <br />LL <br />PLAN CHECK NUMBER <br />�G/7U'Q C/ <br />/ J <br />PLAN <br />FEE �S <br />� <br />CHECK Fit <br />RfEF APT ND <br />(� 1 <br />USF ZONE <br />3 <br />LOT AREA J. <br />I G�Cl. 8sr <br />VACANT SIIE <br />EYES 1<0 <br />FITS <br />VALUATION <br />FEE <br />TYPE OF CONST <br />L H12 <br />OcUPA C _GROOUP <br />GQ <br />NO OF OWEIIINO UNITS <br />BUILDING <br />Si <br />-Sint, <br />cc <br />SIZE OF SLOG <br />-P91S7"IAXc <br />FIRE ZONE <br />T <br />NO OF STORIES <br />2 <br />BASEMENT Hk „ROOMS <br />MAX OCC LOAD <br />FIRE SPRINKLERS <br />IT[QUIRED <br />1-WES nNO <br />PLUMBING <br />MECHANICAL <br />28 <br />S <br />rnc <br />APPROVALS <br />BY <br />DA71 <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC <br />SEC lORa) <br />2 BUILDING PLANS <br />TOTAL <br />S41V <br />S FIRE HYDRANT <br />4 fIRE PROTICTIONSYSTIM <br />-- <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINGIIXLAVATIONACIEARINGiGRUBRING <br />B DRAINAGE <br />7 INVIRONMENTAL IMPACT SIATTMENT <br />B -HEALTH DISTRICT <br />APPI I A:IUN ALL. HA PUNS LHILM I <br />