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r <br />� <br />lheEwrB�� APPLICATION F(��R <br />CITYOF CONSTRUCTIO�. <br />everett PERMIT <br />DEPT. OFCOb1MUNITY DEVELOPMfNT SERVICES <br />CITY HALL 259�8745 <br />EVERETT,\NA98201 �COMBINATION �IBUILDING ❑MECNANICAL ❑PLUMBING PERMIT NO. <br />O\4'N�R AQII �UUN[SS <br />��c�,�sr,� � �i.'L�.'� 7nD3 <br />�PbllilfT OR []19CK�R nuR npDNUS <br />everetl <br />e <br />21P PMON[ <br />9�f'.,� 0 3 �3s�� - sd�� 9 <br />ZIP <br />GfulR�ICO�INnROR n1nILnODRE55 CIIV 21P PMONF llC[HS[� <br />(91v�✓C'� <br />Mf[NntiIUICOMR�CIOR M1InIl�00Pt55 CIIY tIP PMON[ UCFnSF1 <br />PWA1pl\L CONiNnQOR <br />MAIt �DDRF55 <br />CI1� 21P <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOUTION �FENCF ❑SIGN ❑GARAGE ❑�UILDING RELOCATION <br />vniwnov or �.oua <br />S S�Q- d� <br />UIS[FIPf ��ON� <br />u � �/,,� De wa � c � �./�T �o �s� /3' �'� /' <br />raorosmvu or. noinr, i I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />ltGl C <br />�o� � <br />ion <br />0��'.f'P�Nc/ <br />fl0`I Of PRpPLP1Y ISNONN flFl01v <br />PIOC� / o� �'ver, <br />PlUM81NG <br />NO. TYPE OF FI%TUR <br />1vATER ClOSET ITOLIfTI <br />HATHTUB <br />lA\'�TORV pVASN OASIN� <br />$HO\4ER <br />KIIUItN SINK 8 DISP <br />�ISwnSN[e <br />LAUNDHYTRAY <br />CIOiMLS ��'ASN[H <br />WAiLR NEA7ER <br />UNINAL <br />ORINK WG fOUNTAIN <br />FLOOR DRAIN <br />VACUV�� ORUAf R$ <br />NOOf URAINS-RAINIUDERS <br />SINK ISENVICf -OAR, E1C 1 <br />U5f ZON! <br />TYP[ <br />SIZ[ <br />fIRE <br />SUBTOTAI <br />1'ERMIT <br />TOTAIFFE <br />STRE[T SCTBA <br />LOT ARU <br />OCCUPANCY( <br />NO O�STORI <br />A�: ROVAlS <br />1 ENVINUNMWTAICHECKlIST <br />a auaou+� ruNs <br />J iIRF NVORANT <br />� FlHE PRO7lCTION $YSTEM <br />5 GNAUINGII%UVATION6ClIARINGIGRUtlI11NG <br />6 ORAINAGE <br />7. [NVIRONMfNTAL (MPACT STATCMENT <br />E ME�LTH DISTRICT <br />PLIr�TION AND KNOW THE SAME TO BE TRUE AND fORRECi ALL <br />S� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />�?r� OF WORK WILL 6' COAIPLIED WITH WNFTHER SPECIfIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />G�VE AUTHORITY 70 VIOL�TE OR CANCEI THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />$IGNATUNF Of CONTHACTOR Ok AUTMORIZ AGFNT DATE <br />///J � 1 <br />�( -�i�'.iG'%l�c� � </_C� �.�7 C <br />MECHANICAI <br />LFF NO. TYPE OF EQUIPMENT FEE <br />�S <br />RUR Y1RU 5[TBACI <br />\'ACANT SI7E <br />❑1F5 CNO <br />NO OF DN'ELIING l <br />Mnx ott tonD <br />flNt SYPINRlfRS <br />0.fQUIRFU <br />C1YE5 r��0 <br />!Y DATF <br />APPLICATION ACC BY PlANS CHECK[D 9Y I �PPR fON ISSUANCL 11Y <br />9 1-79 <br />AINCOnD UNlii—MP EA <br />HEfHICERATIONUNITS—HP FA <br />HOILERS—MP EA <br />CAS iIREO AC UNIT$-TONhAG[ EA <br />fORCCO AB SYSTG6-H I U M E� <br />U'ALl HUT[RS-II T U M <br />UN�I NfATENS-tl 7 U M <br />R'A^ONATI\'F COOLENS <br />CtOTMES DRYfNS <br />VLNfIUiION f�N <br />RANGfHOOU <br />AIN MANDLING UNIT- C F M1I <br />STOVF <br />MCTAI FlRFPUC[ d CHIMN[Y <br />PUN CH[CI: <br />fEFS <br />SU! TOTAL s <br />�FRMIT s <br />PUN CN[CK FfF <br />FEE I RKEIPT NO. <br />IIUIIDING s s� v <br />rwn�uir+c <br />MfCHANIGI <br />OTH[R <br />PWAITY UOC <br />SEC JOHaI <br />TOTAL <br />![�MIT VALIDATION <br />wlIEN PROPFRLY VAI�DAlEO (IN iH15 SPACEI TNIS IS YOUR PFRMIT <br />` <br />� <br />i <br />• � <br />