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. , <br /> - - �PLICATION FOR�� ����„ <br /> "�`� ���,'�"`'° � �,ONSTRUCTION � � �� � <br /> ever�tt PERMIT <br /> DEPT.OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259-07�5 <br /> EVERETT,WA9D301 ��nMBINATION � BUILDING ❑MECH.oNICAI ❑PI.UMBING PERMIT NO. , <br /> OWNER MAII AODNE55 D UtY 21P PNONE � <br /> � rr�n�� L l��rscAr�D 3�� lh�� �f�f'Tf' �d/ Z�-37sL I <br /> �c� � �w <br /> MCHITFCT OII DBIGNER M�II�D�RF55 CITY 21P , PHONF <br /> � ERALfONTI1�CiOR AUII AODRF55 CIIY i1P PHONE LICENSF I I <br /> �KF <br /> MECH�NIUL CONTII�CTOR MAIL�DDRF55 CITV tIP PNONF IICENSE I <br /> � � <br /> tIUMEINGfOHTRACl011 MAll�00RE55 CITY 21P PNONE I�CEN5E1 I <br /> I <br /> � CU55OFWORK <br /> ❑NEW ❑ADDITION �ALTERATION ❑REPAIR ❑DEMOLITION ❑FFNCE ❑SIGN ❑GARAGE ❑BUILDINC FELOCATION I <br /> . ' vnwnnor+awatK ! <br /> � s � <br /> i oEsc�ie¢wo�K L1UE LA��" � �lN , L / f� ' <br /> � I <br /> i ' <br /> �oroscouscoreuitoir�c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> - iee�ioexximonoF n�onRrr�,Howp eEiQW OIIAi�CN fOURCOFlF51 PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE <br /> (/ OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> � iar�xaK�uv 1 � ^� 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 LOGL LAW REGULATING CONSTRUCTION I <br /> .. y OR THE PERfORMANCE OF CONSTRUCTION. I <br /> �' ' � SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> t I <br /> s <br /> �p i '� ` IO�A000. S y J I X / � � <br /> t ,v <br /> 4 I <br /> �,��^ .- .'.; r � �WMUNG ME � <br /> � � t<. <br /> �` �p, ME pF fIXTU�E FEE N . TYtE OF EQUI�MENT FEE I <br /> ;� V; �[ ,. WATEIlClO5E7ROl�ETI AINCOND.UNrtS-H.P.EA <br /> �� '�+� 6ATNTUB REFRIGER�TION UNITS-HP.EA ; <br /> �';�'.,�;�:.;�� � <br /> � ' 'Y LAVATONY(WASH BASIN) 801LER5-H.P.EA <br /> ' . ;T.�.•� SNOWER WS FIREU A.C.UNITS-TONNAGE EA I <br /> � -'���'�,' FORCED AIF SYSTEMS-B T.U. M EA I <br /> �(( �� � .,F ��. .. KITtMEN StvK i DISP. <br /> '� � DISWASHER wAIL MFATERS-B T.U. M , <br /> ` ' i UNITHEATfRS-B.T.U. M <br /> L�UNORY TR�Y <br /> CIOTHES WASMER kVAPORATIVE COOLERS <br /> �� � � WATER MEATFII CLOTHES URVERS , <br /> � ' � � � URIN�L VENTIIATION FAN <br /> �� � DRINKING FOUNTAIN RANGE HOOD <br /> y fLOOR DRAIN AIR HANDLING UNIT- CF M. <br /> �� � � VACUUM BREAKERS STOVE <br /> . ROOF ORAINS-RAINLE�DERS MEUI FIREPIACE 6 CHIMNEY <br /> � SINK RERVICE-B�R.ETC.) <br /> I <br /> � <br /> I <br /> ' � SU/TOiAI SU�TOTAL � <br /> � RRMIT f ►EIIMIT f <br /> iOiAl fEE f iOTAI FFF f <br /> jiSIDf YARD SETBACK STRECT SFTBACK REAR YARD SFTBACK PUN CHECK NUMBER PIAN CHECK FEE <br /> ` FEE RECEIPl NO. <br /> �,� USE ZONE lOT�REA y���NT SITE . FEES VAWATIOH FEE <br /> �� � � �YES ❑NO . <br /> I TYVE OF CONST. OCCUPANCY GROUP NO.OF DWELIINC UNITS <br /> ' BUILDING s s00�d <br /> �� � SIZE OF BLDG. NO.OF STORIES MA%.OCC.IOAD <br /> i PWMOING <br /> . ' FIRE ZONE BASEMENT BIUROOMS REQUIM1EDKLkRS MECHANIUL ' <br /> OYES ❑NO <br /> AMROVAIf �Y DAiE OTHER <br /> L ENVIRONMENTAL CHECK LIST PFN��T� U.P.C. ' <br /> SfG.10.�a) <br /> 1. BUILDING PUN$ <br /> 7. FIRE HYDRAN7 i�iA� S <br /> 1. FIRE PROTECTION SVSTEM PEIIMIT VAlIDA710N <br /> WHEN PROPERLY VALIDATED(�N TI{�5 SPACE)THIS�5 YOUR PERMIT <br /> 5.GRADINGIE%UVATION 6 QURINGIGRUflNING <br /> 6. ORAINAGE � l.,�= C. i I h--t : -i:� 1��.� ' '� <br /> ,=�.P -.� "� <br /> : r ; <br />