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r -� <br /> APPLICATION FOR ���rc„ <br /> '"'E"ro'"° CONSTRUCTIOI . e <br /> cm oF <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVEIOPMENT SL'RVICE$ . <br /> CITY HALL 259�8715 <br /> EVERETT,WA 98201 ❑COMBINATION C�UILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWN[R MMI�U�N[SS CITV ZIP PNONE ' <br /> j'�N� -- ,.•>.H���a,✓ ,coo ,...�A,�,o F�d,� �d�.e�,-r 9�zo� .z.sz . l�o� <br /> ARCMITlCT OR Ol51GNLN M�II��DRI55 CIiY ZIP PHONF <br /> X�G[NfN�I CONiRACLOR M�II�DOPE55 CIiY 21P PNONE UCFNSE I <br /> \ <br /> ��ICIUMUI CONiRACl00. M�II�DOR[55 fllY LIP PHONE IICENSE 1 <br /> � PIU.��PitiG[OMR�CfOR MMl AOOR65 ���Y ZIP PHONE UCENS[/ � <br /> CU55Of WOXK <br /> ❑NEW ADDITION ❑ALTERATION ❑REPAIR ❑CEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> V�l W�ION Of NONK <br /> S �� <br /> Df SCRIP!\vORK ^�' /J � <br /> �v �'/(/ � <br /> �rr.ovos us�or ntim��c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> p d�� c ,P PLICATION�ND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> IEGAI O(SCRIPIIO^10i PROPIRiY�SHOWM 8[lOW O0.�11ACH fOURCOPIfS� PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> t lpt�BIOCK��Of c' :r OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> A ,� T �— ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> — OR THE PERFORMANCE OF CONSTRUCTION. � <br /> � _ S SIGNATURE OF CONTRACTOR OR AUTMORIZED AGEN7 DATE <br /> ✓�. n- � . <br /> ion nooa[55 � � <br /> PIUMlING MECHANICAI <br /> NO. TY►E OF FI%TU�E <br /> FEE NO. TY►E OF EQUI�MENT FEE <br /> WATEH CiOSET�TOLIEiI AIR COND UNITS—HP.FA <br /> PATMTUB REfRICERATION UNITS—H.P.FA <br /> LAVAT08Y(WASH B�SIN) BOILER$—M P. fA <br /> SHOWFR GAS FIRED AC 11N1T5-70NNAGE FA <br /> KITCNEN SINK 6 OISP fORCFD AB SYSTEM$—B.T U. M EA <br /> OISW�SNER W�«HEATERS—B T.U. M <br /> LAUN�RYTRAY UNITHEATERS—flTU. M <br /> CIOTNES WASHER E\'APORATIVE COOLfRS <br /> WATER HEATER CIOTHES DRYERS <br /> VRINAL VENiIL�T�ON FAN <br /> ORINKING FOUNTAIN NANCF HOOD <br /> FLOOR DRAIN AIR HANOLINL UNIT— _ CiM. <br /> VACUUM BHFAKER$ STOV[ <br /> ROOF DRAINS—H��NLEADERS ME1Al FIREPIACE 8 CHIMNFY <br /> SINK 6ENVICE—PAft,ETC� � <br /> SU�iOiAl � <br /> SU/iOTAI � <br /> rF�Mli f rElM1T <br /> ' f iOTAIfFF � <br /> TOiAI FFF <br /> PLAN CMECK FEF <br /> SIDf YARD SCTPACK STRFET SCTflACK R[�0.YARD SETBACK P�CHECK NUMBER FEE 6� RECFIPT NO. <br /> � �i�y� — ����a <br /> USE ZONF � lOT ARFA VACANi SIT ��Ey VALUATION i!F <br /> OYES <br /> i <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELUNL UNITS <br /> 5/"- �LJ — —' eunoir+c s2700• 38 <br /> ' SIZF OF BLDL NO.OF STORI[S MA% OCC LOAD <br /> ' �. � PLUMAING <br /> fIRE ZON[ B�SfMENI OIDilOOMS FIRE SFRINKLCRS J <br /> REQUIRFD . M[CHANIUL <br /> � — -� —' OYfS 6NO� <br /> �M�OVALS �t D�iE OTMFR <br /> 1 FNVIRONM[NTALCHfCKL15T pFNALTY U.BC. <br /> SEC.ION+I <br /> 2 BUILOINC PL�NS iOiAl <br /> J iIRF MYDRANT <br /> � FINE PROTFCTION SYSTEM ►EtMIT V�LIDAiION <br /> r WHfN P0.0PERlY VALIDATFD(IN TMIS SPACF�THIS IS YOUR PFRMIT <br /> y 5 GRADINGIt%G�'�110N8QEARINGIG0.UBflING <br /> 6 DRAIN�GE <br /> L fNVIRONMENTALIMPACTSTATFMENT <br /> E HFALTH DISTRICT <br /> APPLICATION ACC.BY PLANS CMECKEO BY A►PR.FOR ISSWNCF BY <br /> h!� �}Wr� L ' �' <br /> 41�79 <br /> • a <br />