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,�.EWro�.� APPLICATION fOR <br />CITV OF !Y!f!M <br />everett � STRUCTION e <br />DEP7. OF COMMUNITY DEVELOPMENT SERVICES P E R M I T <br />CITY HALL 259�8715 <br />EVERETT, WA98201 �COMSINATION Q SUILDING ❑MECHANICAL ❑PIUMlING PERMIT NO. <br />OWNlR MAII � ONl55 CIIY ZIY �qpryp <br />i�/-���f �'S � SI��D uJ %,zY(o'�A,vn G✓G�t'G�9.Fzr/ a�S� •�3/l� <br />�ItCNIf[U OF D[SIGN[R <br />G[nq��[OMq�CiOR M�Il�00Rt5S CI1Y <br />'-.. � • _ ` _ ^ . � � _ _ 21P �NON( U[ENSF 1 <br />-._.-.-.-..•--•.•^^..�� mn�lnUURu) CIIY LIP PNONf UCLNS[I <br />PIUmPI`�G[ONtR�CtOR MnIIAD�R63 U�Y ZIP pNOHE tICFNSEI <br />C�I��SS Oi WONK <br />'LJNEW ❑ADDITION ❑AITERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />V�lWll Of /N('ORk'] <br />f // )�/�. !� T <br />WORA <br />VROVOSf0U5f O( PUIIDiNG <br />ltG�l D[SCRIPiION O{ PFOPFRiY �SIIOW N pEIOW OR �iLACN fOUR COPIFS) <br />io� _eiocK_or <br />IOP <br />fIUM�ING <br />NO. TY�E OF il1ITURf <br />WATE0. CIOSET ITOUET� <br />BATHTUB <br />UVATORY �WASH PASIN� <br />SMOwER <br />KITCMfN SINK 8 DISP <br />LAUNDRY iRAY <br />CIOTHES WASHFR <br />WATEA HEATER <br />URINAI <br />DRINKINC FOUNTI <br />iLOOR ORAIN <br />V�CUUM BNF�KFR <br />ROOF URAINS—R/ <br />SINK ISERVICE—BA <br />Y�RD <br />TYPE OF CONST <br />R�MIi / <br />TOTAL IEF � <br />STREET SETBACK RCAq YARD 5 <br />LOT AREA VACANT SITE <br />OYES ❑NO <br />OCCUPANCY �ROUP NO.OFDWFI <br />ArMOV�If <br />7 ENVIRONMENTAI CHECK LIST <br />i. BUIl01NG Pl�NS <br />J FIRF HYDRANT <br />�. FIRE PROffCTION SYSTFM <br />S GR�DINCIf%C�VATION6ClEARINGIGNUBRINC <br />6 ORAINALE <br />7.[NVIRONMFNTALIMPACTSTATEMENT <br />E. MEALTH DISTRICT <br />�r <br />fFE <br />DAiE <br />APVLIC�TION ACC BY PLANS CHECKED BY I APPR FOR ISSUANCE 9Y <br />9.1 79 <br />I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS AP- <br />PLICATION �ND KNOW THE SAME TO BE TRUE AND CORRECTALL <br />PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANiING OF A PERMIT DOES NOT PRESUME TO <br />CIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW RECULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />51^ TU0.E OF CONTRACTOR OR A�RIORIZED ALFNJ DATf <br />Tt/E OF EQUI�MENT <br />AIR COND UNIiS—H P EA <br />REFRILERATION UNITS—HP. EA <br />AOILFRS—H P FA <br />GAS FI0.FD A C UNITS—TONNAGE EA <br />LORCkD AIR SYSTEMS-9 T U M <br />WAILMFATERS-9.TU. M <br />UNITMEATERS-81U. M <br />EVAPpRATIVE CWLFRS <br />CLOTMFS DRYERS <br />VFNTIL�TION FAN <br />R�NCFHOOD <br />AIR H�NOLING UNIT— �.FM. <br />STOVE <br />MFT�L FIREPUCE 6 CHIMNFY <br />PUN CNECK <br />MIT f <br />IAl iFE f <br />PLAN CMECK FEF <br />FEE RECEIPT NO. <br />VALUAiION �[F <br />BUII�ING f <br />YlUM81NG <br />MFCN�NICAL ' ' <br />�� <br />OTMIR <br />PFN�LTY U.BC. <br />5EC lOHa) <br />70TA1 ' 1 <br />U— <br />►EIIMIT VALIDAiION <br />WHEN P0.0PERlY VALIDATED �IN THIS SPA[EI TNIS tS YO�1R PERMIT <br />