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r <br />r <br />4PPLICATION FOR <br />Ins Erergreen everen <br />��TM°F CONSTRUCTICaN �, <br />everett PE RM IT <br />DEPT.OF COMn7UNITY DEVELOPMENT $ERVICES <br />CITY HALL i59�8745 <br />E"�aeii.w'neezot �COA4BINATION ❑ BUILDING ❑MECHANICAL ❑PLUMRING PERMIT NO. <br />ONNlR MAII AO�N155 CI11 ZIP �IIOfM1f <br />.7/F_a..it>A-/� � 7'��/: i7.7s .2Y�1 14�.•�./s,£', ��r_•� `f��-/�'�! <br />ANCMRtR OR Ut9CvlF MAII eDONlSS CIiY ZIP PMOM1f <br />GIM1(R/�ICOtiIRA(100. M1qll,\D�NI55 Ull ZIP YHO4[ IICEHSII <br />ivE2T�`� � rP�+.•s c <br />M�HA/Si./✓ %17-15� /V E, r�Ll2liz/u �l�227 (OS�-7.2Y� 2��kt <br />vICHAFIUICOtiiR�QOR MAIInUONF$S ❑1Y CIP VIION[ lK[NSE� <br />P�P��pi�G [ONIPAC100. M�R nDDNl55 U1v bP PHO�F UClNSf � <br />( l �55 UI NORK <br />❑NEV.' ❑ADDITION <br />\'MU�11.lvOfN NK <br />f � %% �% <br />❑ISlNlt11 NOXA <br />raoroao ou or xwioi+�c <br />❑ALTERATION �REPAIR ❑DEh70LITION ❑FENCE ❑SIGN ❑GARAGE ❑6UILDING REIOUT�ON <br />llCnl OLS(RIP�I04 Of PFOPlPiY ISMpN�+ NLION ON Al1nCM 1000. COCII51 <br />l Ui �� HIOCA �_ �f <br />�ounnU�S � <br />YLUMBING <br />NO. TYPE OF FI%TUNF <br />N'ATFR CLOSLT�iOLIETI <br />ItAiHTU� <br />5110W k N <br />AIiO1EM SINN 8 �ISP <br />D6W/SH[R <br />lAl1NDRY iRAY <br />CLOIMfS WASH[R <br />R'Ai[N MEATLN <br />URIrvAL <br />DRINKING FOUNiAIN <br />IIOOR DRAIN <br />VACU11A1 tlHEAKE RS <br />NOOf URAINS—RAINIEAOERS <br />SINN 6ER�9CF—OAR ETC � <br />SIDF Y�HU 5! iP. <br />USf ZOf:E <br />iYP[ OI CONSi <br />S12F OF IfLDG <br />SUJTOTAI <br />PEPMIf 1 <br />TOTAIf[F S <br />STftE[TSCiIIACN R( <br />IOT AREA <br />OCCUPANCV GHOI/P <br />NO OF STORI[5 <br />VAUNI SI1L <br />❑YES Cr�O <br />NO Of DWfL <br />n1A% <br />FEE <br />fINC 20N[ � NASCMFN7 I111>HUUntl RFV�IRED����� <br />I!YFS f�NO <br />APIROVALS EY OAT[ <br />1 E�A'10.0`1ntINiAL GH!Ck l67 <br />z eun�u+c vinr+s <br />) flHf H1DkAN7 <br />t fIRfPFUTEC110N5VSTEM <br />5 GNAUItiQI%U\'A710NbCllAXING;GRUNNWG <br />b UNA:NACE. <br />] EM'�POrvn1ENUL IMPACT STAT[b1LNi <br />E HUl i M DISTRIQ <br />APPIICAIION ACC BY PUNS CHEIXED BY � APPR iOR ISSUANCf BY <br />9 1 79 <br />c� c�rTK ti�u� <br />I HERF�Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAM`e TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED N'ITH WHETHER SPECIFIED HEREItv <br />OR NOT. THE GRANTING OF A PERMIT DOE$ NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />Ah.'V OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGN�,T R[ UF CO TN TOft N AUTHORIZ[D AGFNT DAT[ <br />/ �2 -�Y-�7 <br />X '� ,� <br />MECHANICAL <br />NO. YPE OF EQUIP.MENT <br />AIHCOND UNI75—HP U <br />RIfRIGENATIONUMiS—MP U � <br />OOILEHS—M P EA <br />GASfIHLp AC UNRS-70NNAGEFA <br />fONCEDAINS�5TEb15—BTU M <br />VVAII HkA7LR5—B 7U M <br />U'+�i HUTfP.S-117 U M <br />I VAPORA7IVF COOI[RS <br />CLOilll S ORYFRS <br />Vf NiIUTION UN <br />RANG( MOO� <br />Alµ MANDLING VNIT— C f M <br />M11I7A1 IIREPUC[ 8 CHIMNEY <br />SU9TOTAL <br />PERMIT <br />TOTAI/[E <br />PIAN CM[CR NUn10kN <br />ftE <br />RES VAIU�TION <br />fEE <br />� <br />3 <br />S <br />CHFIX FEE <br />NEC[IPi NO <br />f[E <br />IIURUING s <br />PI Ub1NIYG <br />MI OI,\NIUI <br />OTMFR <br />rtr+utr uuc <br />5[C )oJfa� <br />TOIAI <br />�ENMIT VAIIDATION <br />WNkN PNUPENLY VAlID�lfpliN IIUS SP�Cf I TMIS IS �OUN C(XMIL <br />�� <br />i■ <br />, � � <br />