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ARPLICATION FOR ' <br />�� "' �,�NSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVEIOPMENT SERVICES <br />CITY HALL 254e7I5 <br />EVERETT,WA9E201 �COM/INATION .�lUILDING ❑MECHANICAL ❑�LUMSING PERMIT <br />OWNt■ M�II �DDN65 CITY '^ �P _. ' rn�E[�, � I <br />�� <br />e <br />GEM[IIAI CONiLLACidI <br />I.UII AODRESS CITY 11P �NOME IICENSE I <br />MfCM�HIUI CONTMdO� <br />MIR �ODI165 CIIV llt MONE UCENS[ � <br />��Tt Z�� PNOME LI[ENS[ � <br />PWM111NGCOHtteCiOR ������DORESS <br />CUTS Oi W�R <br />❑NEW ❑ADDITION QALTERATION .�IREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE BUILDING REIOCATION <br />W1U�110NOi WO�K <br />OESCIt�sf W� � I \�o P�uMB/N4 oR <br />' _ __.' � _. �. /..._� ..� . �..v a..�,M l FIFLTRIfAL GfIM/L1 <br />USF Of <br />IFG�I OETC¢I�TION O' AOtF11TY �SNOW H lElOw OR �iTeCM <br />ioi� �•1 e�aa 73 a FVER �:TiTDI I <br />/YCO�S OF Tl�t�ua��foY <br />10l�UWESS � <br />�IUM�ING <br />USF <br />DISP <br />fU� <br />lOi �REA <br />TYPF OF [um� ..........�. _..__. <br />S�ZE Of BLDG NO OF STOnI[S <br />FVE ZONF BASEMFNT flkON( <br />ARlOVAIi <br />1 ENVIRONMENi�I CHECK lIST <br />7 BUIIDING P\ANS <br />J RRF HYDRANT � <br />♦. FBf PROTfC710N SYSTfM <br />S LRAOINGIf%GVATIONBCIEARINUCRUBN�NG <br />6 DR�IN�GF <br />L ENVIRONMFNTAIIMPACTST�TFMENT <br />0 HEAITH DISTRICT <br />V V I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br />� }IE�4 .. PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />coritsi PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />„ +� OF WORK WILL BE COMPLIED WITH WHETMER SPECIFIED HE0.EIN <br />� OR NOT. THE GRANTINC OF A PERMIT DOES NOT PRESUME TO <br />A YEOTHER�STATE OR LOCAL L W EGULATING CONSTRUOCTION <br />OP, THE PERFORMANCE OF CONSTRUCTION. <br />I SICNATURE OF CONTRACTOR OR AUTHORIZED �GFNT D�lE <br />X <br />MEfMANICAI <br />NO. T11E Oi EQUI►1 <br />I11R CONO UNITS—H P. F� <br />REFIIIGERATION UNITS—H P. I <br />BOIlERS—H P. EA <br />G�5 FIIIFD AC UNITS—TONN <br />FORCf D �IR SYSTEMS— B T U. <br />WALL HE�TERS—B.TL <br />STOVE <br />f <br />1 <br />RE�R YARD SE78�CK PIAN CNFCK P <br />VAUNT SITF � <br />OYES ❑NO <br />NO OF DWELL�NG UNITS <br />BUILDING <br />MA% OCC IOAD � <br />PLUMBING <br />fIRF SPRINKlERS <br />NEQUIRED MECH�NIUI <br />❑YFS ❑NO <br />�r D�tt OTHER <br />PFNAIiY <br />BY PlANS CMFCKED BY APPII. fOF ISSUANCF BY <br />FFE <br />S <br />U.B C. <br />SEC. loll�l <br />RECEIPT NO. <br />TOiAI I � <br />►lllMli V�IID�TION <br />WMEN PROPERLY VAIIDATEU pN TM�'. SPACE) THI515 YOUR PfRM1T <br />