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FM EwMmn <br />CITY OF <br />t-PPLICATION FOR <br />CONSTRUCTION <br />everett PERM) IT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 COMBINATION <br />BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />creretl <br />e <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE R <br />GENERAL CONTRACTOR <br />CITY LIP <br />PRUNE LICENSE <br />MICHANICAI CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE IT <br />^IUMBINC. CONTRACTOR <br />MAIL ADDRESS <br />CLASS OF WORK <br />❑REPAIR <br />❑DEMOLITION ❑FENCE ❑SIGN <br />❑GARAGE ❑BUILDING RELOCATION <br />❑NE\V ❑ADDITION <br />ALTERATION <br />VAIL'AHDN OF WORK <br />S ?OU Oy - <br />DISCRIBf WORK <br />..^.. Al F� ()< <' VE <br />I HAVE READ AND EXAMINED THIS AP- <br />PatD usl or Bunowc I <br />PLICATION <br />HEREBY CERTIFY THAT <br />AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS <br />OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />IGAI DISCRIPTION01 PROPIRtt (SHOWN IkIOW OR ATTACH LOUR COPIES' <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />Joy _BIOCK -OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />GIVE <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />ANY <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE <br />OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />n /o/z <br />ION ADD RF 55 4 <br />y CCf <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF EQUIPMENT FEE <br />NO. TYPE OF FIXTURE FEE <br />AIR COND UNI75-H P EA <br />WATER CLOSET (TOLtETI <br />REFRIGERATION UNITS-H.P EA <br />BATHTUB <br />BOILERS -HP EA <br />LAVATORY (WASH BASIN) <br />GAS FIRED At. UNITS -TONNAGE EA <br />SHOWER <br />FORCED AIR SYSTEM$-B T U M EA <br />KITCHEN SINK & DISP <br />WALL HEALERS -BTU M <br />DISWASHER <br />VNIT HEATERS -BTU M <br />LAUNDRY TRAY <br />[VAPORATIVE COOLERS <br />CLOTHE$ WASHER <br />CLOTHES DRYERS <br />WATER HEATER <br />VENTILATION FAN <br />URINAL <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT- C F M <br />S <br />FLOOR DRAIN <br />STOVE vp� <br />VACUUM BREAKERS <br />METAL FIREPLACE & CHIMNEY <br />ROOF DRAINS -RAINLEADERS <br />SINK (SERVICE -BAR. ETC I <br />' <br />SW TOTAL y Sa <br />SUN .7TAl <br />PERMIT y U d <br />PERM)' <br />S <br />TOTAL F[F y <br />TOTALITIES <br />S <br />HE <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />NO. <br />SIDE YARD SETBACKTNoOT <br />K REAR <br />YARD SETBACK <br />FFE <br />FEES VALUATION FEE <br />USE ZONE <br />VACANT $ITE <br />❑YES ONO <br />TYPE UL CONST <br />ROUP <br />NO OF DWELLING UNITS <br />BUILDING S <br />SIZE OF BI DG <br />S <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE BASEMENT Bll1ROOh15 <br />RFQ Rt SP EIDNKLFRS <br />MI CMANICAL <br />�IVFS FINO <br />AP►ROVALS <br />IT DATE <br />OTHER <br />PENALTY <br />TOTAL <br />LIFE SF <br />SFC )o al <br />1 ENVIRONMENTAL CHECK LIST <br />2 BUILDING PLANS <br />) FIRE HYDRANT <br />♦ FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />W LIEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />5 GRADINGIE XCAVAT ION& CLE ARINGIGRUBBING <br />& DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />5 HEALTH DISTRICT <br />APPI ICATI(l4 ACC BY <br />rl A4A CHFCKFD BY <br />APPR IOR ISSUANCE BY <br />