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-4PPLICATION FOR <br />'".E"ro'"" CONSTRUCTIOh <br />�,rof <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259�8745 <br />EVERETT, WA9B201 ���Mg�NAT10N ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />���rcn <br />e <br />RCMITKiORUFSIGNIR M�IIADDRISS CIiY ur rn�ne <br />GfNfRAICONIN�Ci00. M\IIApORFiS CIiY 21P ^ PHAN[ M^ IICENSEt <br />_ . . i] n /i _ � .. , � / <br />LIP <br />PlUnlfll\GCONIN�OOR M.JLAOD0.[A CI�Y ZIP PMONE IICFNSE� <br />CUSS Of wOPN <br />❑NEW ❑ADDITION CIALTERATION ❑REPA�R .�DEMOLITION ❑FENCE ❑$IGN ❑GARAGE BUILDING RELOCATION <br />V�IU���ON Oi WOPR <br />f <br />OfSCNiPf WORk � � �� <br />/ �i�. -�� f i��"LG-6l <br />CROVOSI O U51 01 P�rtOiMG <br />lFGel D6C0.1PlION Ot PNOPEFiY ISNOWN flEIOW aR n1inCH �fOU�/R COPI <br />l01%�-S�/•%dl�[K�Oi / ./o��a fff�'l' <br />/ i'/J O ✓..P �� <br />IOPn00Rf55 / // N�� <br />�/ �0 f (/% / 7T rv <br />pLUMlING <br />NO. TYrF OF il%TURE <br />W�TFN CLOSET ITOIIEi) <br />BATMTU9 <br />LAVATORY�WASM BASIN� <br />SHOWER <br />KITCHFN SINK 6 DISP <br />UISw�SHER <br />LIUNDRV TRAY - <br />CIOTNES WASMER <br />WATER HEATFR <br />URINAL <br />DRINKINC FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BRUK[RS <br />ROOF DR�INS-RAINIF�DFRS <br />$INK ISFRVICE-BAN, EIC 1 <br />fU�TOiAI <br />►FIIMIi f <br />iOiAIFEF f <br />..._...........e.�.. <rvsti SfiN�CN RUR <br />ZONf <br />TYPE <br />FIRE <br />LOT <br />M►�OVALS <br />1 ENVIRONMfNTALCMECKLIST <br />7. BUIIOING PUNS <br />7 fIRE MYDRANT <br />� fIRE PROTECTION 51'STEM <br />5 GRADING!l%UV�TION6CLURINGILRUBflING <br />6 DRAINAGE <br />L FNVIRONMFNT�L IMP�CT STAT[MENT <br />E NFALTH DISTRICT <br />APPLIGTION ACC. BY PtANS CHECKFD BY <br />g.t�79 <br />1 NEREBY CERTIfY THAT I HAVE READ AND E%AMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />51 PROVISIONS OF LAWS AND ORDINANCE$ GOVERNING THIS TYPE <br />OF WORK WILL BE COMf' �ED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTIN[. :F A PERMIT DUES 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 CONSTRUCTION. <br />SIGNATURF OF CONT�ASJOR�OR �UTMORIZED AGENT DATE <br />FEE NO. TYPE OF EQUI�MENT FEE <br />AIH COND UNIiS-M P EA <br />REF0.ICFRATION UNITS-HP EA <br />BOILERS-HP EA <br />GAS FIRED A C UNITS-TONNAGE E� <br />FORCED AIR SVSTfMS-B T U M EA <br />WALLHEATERS-B.TU. M <br />t1NITMEATERS-BTU. M <br />EVAPORAiNECOOLERS <br />CLO7HES DRYERS <br />VENTILATION FAN <br />R�NGFNOOD <br />AIR HANDIING UNIT- C.F M <br />STOVE <br />MFTAI FIREPLACE 8 CMIMNEY <br />SU��OTAI s <br />rF�Mli % <br />TOiALiFE f <br />S[TBACK PL�N CHCIX NUMBfR PLAN CM[CK FEE <br />yACANT SIIF <br />OVE$ �NO <br />NO O� OWfIUNG 11N175 <br />MA% OCC IOAD <br />fIRE SPRINKLERS <br />0.EQUIRFD <br />f7YFS ❑NO <br />/� DAiF <br />FOR <br />FFE <br />RECf IPT NO. <br />�FF <br />UUIIDING s <br />PLUMIIING <br />MECNANIUL <br />O7HER <br />PkNALTY UB.C. <br />SEC IOH+) <br />iOTAI <br />rE11MIT VALIDA710N <br />WNEN PROPFRLY VALIDATFD �1N THIS SPACf) 7M�5IS YOUR PERMIT <br />