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APPLICATION FC�R everetl <br />CONSTR�JCTIO� � e <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259�0745 <br />EVERETT, WA 9P201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />owr�ta nuu nonxiss air zu� r��ou� <br />C. V._�ohncton 930 Grand Ave. E�gre[t 98201 — <br />ARCHR[Q OR OESIGNfN b1Alt �DOR65 [IiY 21P PIION[ <br />LFNfR�LCG�tq�CtON MAII�O�RE55 Ut1' T.IP PIIOu( IKfNSI� <br />Riverside Roof Co. 2916 Sta[e Street Everett 98201 z56-4646 RI-VE-RR[�302T0 <br />AIA1l <br />PLU4101M1GCONIRA(iON M�ILADDRlSS CIIV 21P �MONf lICWS[/ <br />C1�S50i N'OPA <br />❑NFW ❑�DDITION <br />VAIUATION OI �VORK <br />, t,t76.ou <br />OtSCRIPE \YOPK <br />raorosm us� or nmininc <br />❑ALTERATION ❑REI'AIR ❑DEMOLITION ❑FENCE ❑SIGN ❑G�RAGE ❑BUILDING RELOCATION <br />IEGAI 0[SCMIPTION Of PROP[RLY (SMO\1'N pFION' OR �LTACH fOUH COPiE51 <br />�p� PLOCK�Oi <br />100 AUONE Sf <br />PLUMBING <br />NO. TYPE OF FI1(TURE <br />�vwi( B CLOS[ T ROLI! T� <br />IlA7NTU0 <br />LAVATOHY' �\VASH IiA51N) <br />SHO\ClR <br />KRCII[N SINK A DISP. <br />DI$\vA511fR <br />UU'.'DRY TRAY <br />CLOTNf 5 WASNEN <br />Wnl[R HEAiCR <br />DRINKINC FOUN7AIN <br />FLOOR OHAIN <br />\'ACUUM IIRFAK[RS <br />ROO( ORnINS—RAIhIEAU <br />SINA 6[R\9CF—OAN, LTC 1 <br />SUB IOTAL <br />PEPMIT <br />TOTAL FfE <br />SIDC 1'ARU SLTf1AIX SIRECT SETIlACK <br />USE ZONE ��� �N�� <br />TYPE Of CONST. OCNPAhCV GROUP <br />�+ SIZC OF IILnG � h� <br />FEE <br />S' � <br />Rf AH 1'ANU SL iBACR <br />VACANT 511( <br />CYES i:�0 <br />NO Of DIVELLING U� <br />.VA1 OCC IOAU <br />IIRf 7.ON[ IlASLMfY1 I IIIIINI)U�11 IIH! ll'HIN6ltn> <br />HIVUINtU <br />rfti vn <br />APPROV/1LS OY DA7! <br />1 fM1l'IHU���tI�IALIIII(.AIISi <br />: OUILDING PUhS <br />J (IHf NYf]HAY7 <br />� FINI I'NO1FC710��51'STfA1 <br />5 GRAUINGI%CAA'AIIONSCl1ANINf.GHPH111N(�. <br />L URAIn'nGf <br />] fN\'IkUtiVINIAI I\IPAC7 SIAIfMINI _ <br />I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THI$ AP- <br />PLIC�TION AND KNOW THE SAME TO [3E TRUE AND CORRECT ALL <br />PROVISIONS OF L�WS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL 6E COMPLIED WITH WHETNER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES 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 />SIGNATURE OF CONTRACTOR OR AUTHOR2ED AGENi DATC 3-5-gi <br />MECHANICAL <br />TYPE OF EQUIYMrni <br />AIH C�VU UNIR-11 P U <br />Nf 1 NIGL RAT IOM1 UNIiS-11 P[ A <br />❑OILLNS-11 P !A <br />GASIIHfUAC Uti175—IOVNAGf [A <br />FORCEDAINSISIL.VS-117U. �� <br />\t'ALl MiA7lft5—II T U M11 <br />UNI7 Nln11.R5-11T U ht <br />f.\'AP�)RNI\'L COOlFNS <br />Cl G711! :� UHti f Ht <br />vi tirnnnuu iny <br />RANf,I HOOU <br />AIR HANDLING UM!— C F M <br />5T0�'E <br />A1F lAL FBIPUCF A LNIAriFV <br />PIAN CIIfCA tiU,VI7ER <br />I1L'IIPI�G <br />PLU.�1141KG <br />.VFQIANIUI <br />(�IIIIN <br />1'1 �11 il <br />FEE <br />TOTAL s <br />.�ir s <br />ALfEE s <br />PLAN CHLCK iEE <br />f!F RtCFIYT n0 <br />VALUA710N FFE <br />5 � <br />l ❑( <br />)Il 10)lal <br />iOTAI I I <br />PEPMIT VALIDAiION <br />\\'lll � 1'H(11'I HI i\'AIIDATf D IIN 1HI5 $PACF) THIS 151DUR PERMI7 <br />