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APPLICATION FOR �.�«<n <br /> MeEvvOnm � CONSTRUCTIOf� � <br /> cirr oF <br /> everett PERMIT <br /> DEPT OF COMMUNITY OEVEIOPMENT SERVICES <br /> CITY HALL 259-8745 . <br /> eveaeii.wn5azot ��OMBINATION L�BUILDING ❑MECHANICAL ❑PLUMBING PERMIT N . <br /> ��j, Z�p PNONF <br /> M/.Il AOf]Xf 55 <br /> OW4(R ` ' <br /> �1CNfi2J � V � r-1C1L �113L�SL � ZZIIe S53at ��. - EVLIl`.i� - �lk2.U � � S :j'S2s�� <br /> ARCNRfCION�E51CN10. MMLADORE55 <br /> citr zip vHo�[ <br /> GFN[RAlCO"��RnC100. MAllA00RF55 <br /> UiY ZIP PNOnF ll[[NSE 1 <br /> C117 Lip PNOrvE LKEvSE� <br /> ♦tICHANIUICOHi0.�Q00. MAllAO00.F55 <br /> ��i� Z�p VHONE IICErvSE I <br /> 19l'41NIVG CONiqAC10N MAII AOORISS <br /> CLe55 OI N'ORK j <br /> ❑NEW ❑ADDITION ❑ALTERA710N C�REPAIR ❑DEMOIITION ❑FENCE ❑SIGN ❑GARAGE BUILCING RELOGT�ON <br /> �AIU�IIONOf W00.K <br /> 5 �Z U O . O O � �V'C�-T' <br /> ptSCRltl[WOPR — -�i �•�'t�2�i �� �— <br /> P�uT NEv�I Cc:nPtsR�unl �CG < "vY c�z E��>T ��i C Rot. . .�. <br /> rxoroseousF or nmiowe I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> E �� �FL � r, ;` t 5 .�-��R�` PLICATION AND KNOW THE iAME TO 8E TRUE AN�CORRECT ALL <br /> PROVIS�ONS OF LAWS AND ORD�NANCES GOVERNING THIS TYPE <br /> IEG�lDISCRIPiIONOFPXOPl0.1YIN�OKN11[tOWORe1iACHiOURCOPIf51 pfWORKWILLBECOMPLIEDWITHWHETHERSPECIFIEDHEREIN <br /> 4I eic<K_ov T�--�"�w . �--i i �-'tlZ���=�- OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> �O1 — � p_oo GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> c C Q\Y 1 5 , o N u <br /> � ANY OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTION <br /> OR THE PEftFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CON70.AQOR OR AUiHORIZFD AGENi DATE <br /> ,\ (� ��` �1' -i � '� � <br /> ION AJDRf 55 - �. I �� y v My`�__��� � 1J_3_,�XJ�L <br /> _� Z Z 1 G �SA O C <br /> �`r " CJ E�Z C�\ N <.� A . <br /> MECHANICAL <br /> PIUMBING FEE <br /> NO. <br /> 7YPE OF FI%TURE fEE NO. iYPE OF EQU�PMENT <br /> AB C04D UNI75-M P EA <br /> WA7ER QOSCT ITOlIET1 <br /> REfRIGERATIO�vUNITS-HP EA <br /> I1ATHiUO <br /> OOILERS-��F �� <br /> IAVATORYIW�SH BASIN) <br /> CAS FINEO A C U�ITS-TONNAGE EA <br /> SMOWFR <br /> FONCED AIH SYSTEMS-0 T U M EA <br /> KRCHFN SINK 6 DISP <br /> 14A11 ME�TER$-f7 i U M <br /> DISW�SNFR <br /> UNII HUiFHS-P 7 U M <br /> UUhDRV iHAY <br /> f VAPUNATIVE COOLERS <br /> CLOiHES WASMiR QOiHkS DRVFRS <br /> WA1kR H(MFN <br /> V[N71UilON fAN <br /> URINAL pANCF MOOD <br /> DNINKING FOUNTAIY <br /> AIN HANpLING UNIT- C f M <br /> fIOOM DRAIN SiOV[ <br /> VACW�1[1HFAKFft$ <br /> nIEUI FIRfPLAC[ 8 CHIMNEY <br /> ROOf DRAINS-HAINLfAOERS _ <br /> SINK 6ERVICL-NAR.tiC 1 <br /> SUlTOTAL s <br /> SUB TOTAI �EIIMIT s <br /> PFIIMIT 4 7 <br /> S TOUI FEE <br /> TOTAL ifE pLAN CHfCK FEF <br /> 51�[ YAftD SCLOACK STRIIT SRf1ACK NUN Y1RU SIIflACK PUN CH[CK NUA1tl[R <br /> ffE RECEIPT NO. <br /> USE ZONf l0T AREA YAUNT 51T[ F[ES VAIUATION FEE <br /> ❑YFS ❑NO � <br /> 7YPE OF CONS7 OCCU7ANCY GROUP NO O! OWEILING UNI75 <br /> PUIIOING � <br /> NO O�STONIES MA% OCC LOAf1 <br /> SV.[OF E1lDG PWMpING <br /> RHC ZONE 11�SFMENI It10NUUM5 REQUIRFIDNKI[NS MICMANIUL <br /> rnes r�No <br /> APtROVAIS !T DATE O711FR <br /> uec <br /> 1 [NVINONMENIAL CH[CK 115T pkNALiY SEC ]O7(a) <br /> 2 9UIlDING PUNS TOTAI <br /> 7 FIRE MYDRAN7 <br /> �ERMIT VALIDA710M <br /> ♦ FIRE PRO7ECTION SYREM WHEN 7ROPERIY VAIIDATEI)ON 1MI5 SPACE)TH615 YOUR PERMIT <br /> 5 GNADINGifXU\'�ilONBCLFANWGIGNUtlNINC <br /> h DRAINAGE � <br /> 7 ENVIRONMFNTAI IMPACT$iA1EMFNT <br /> 8 NEALTH OISiRICT • <br /> /,ppLICALION ACC PY PLAN$�HLCKED BY �PPR �OR ISSWNCf flY <br /> g.�.;9 <br />