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r <br />the EYlrytRen APPLICATION FOR �Y�,�„ <br />CITY OF CONSTRUCTION - i <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2598745 <br />EVERETT. WA98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />to y[ �Nla MAIL ADDRESS "" �y� lip rnON, <br />I 11 I o Aln t-I—)mc) 1,5c�"c `J. t�Dwz1/l 9 x0ei[/ ---;; 5 3 �c <br />R <br />ATICHIII(TORDISIGNIN <br />O <br />MAIL ADDRESS <br />CITY <br />!IP <br />PIIUNI <br />it <br />LICENSE IT <br />CINIKAI CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />LIP <br />PHONE <br />�I <br />Ift <br />IA <br />I I <br />IL <br />�� <br />Duraw-Ehia" <br />MI(IIAM(M(ONIRMION <br />MAILADDNISS <br />CITY <br />LIP <br />PHONE <br />LICENSE <br />LICENSE I A <br />PLVTVIN(; (ONIRACl)R <br />MAIL ADDRESS <br />CITY <br />LIP <br />PHONE <br />®NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUIEDINC RELOCATION <br />SAIDAIIIIN OI WUXK <br />DHCNINI \)ON♦ � <br />K n A. 0. O <br />PNOPO.D)Cnl OF HUHDINC <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS .AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PFRMIT 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 TH 'ORMANCE OF CONSTRUCTION. <br />SR,N LIRE F ONIRACTOR O UIHORIZED AGENT DATE <br />4 SL_ 3 �5 <br />LEGAL DISCRIPTION DI PMOPIRII INIID N BELOW' OR ATTACK FOUR CQPHSI <br />_ <br />tot-ali1ocKOF <br />IUII eUI)N115 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FE <br />OL <br />WAIIRCIOS11110111Tl <br />AIRCOND UNITS -HP IA <br />BATHTUB <br />REFRIGERATION UNITS -HP EA <br />I AVATORY(WASH BASIN) <br />4 <br />ROILIRS-HP EA <br />S11OWfR <br />GAS FIRID AC UNITS -TONNAGE EA <br />KIIC HEN SINK 6 OISP <br />FORCED AIR SYSHMS-B T U MEA <br />UISWASHIR <br />%VALE HEALERS -BTU M <br />IAUNDNYIRAY <br />UNIT HEAR RS-BIU M <br />Cl OTHIS WASHIIF <br />IVAPORAIIVE COOLERS <br />WAHR HIAIIR <br />C101141S DRYERSURINAL <br />VINIIIAIION FAN <br />DRINKINGfOIINTAIN <br />lig: <br />RANGE IIOODHOOR <br />DRAIN <br />AIR HANDIING UNIT- CFM <br />V'A(UIINI IIRIAKERS <br />S10VE <br />ROOF DRAINS-RAINt I AUt RS <br />Mf1Al HREPIACE 6 CIOMNEY <br />SINK ISIRVI(1 -BAN. 11CI <br />SUB TOTAL <br />SUB TOTAL S <br />'�PERMIT <br />IFPERMIT <br />IFTOTALI[[ <br />S <br />' <br />TOTAL EFT i <br />SIDI TAR[) St I BACK <br />STREET SETBACK <br />REAR YARD SI IBACK <br />PLAN CIIICK NUMBER <br />/ <br />/PLAN <br />It[ '7 <br />CMICK FEE <br />RE Cj IPT NO <br />6 <br />USE ZONE, <br />LOT AREA <br />VACANT SITE <br />FIVES ❑NO <br />FEES <br />VALUATION <br />E!T <br />TYPES Of CON5T <br />=c ` N <br />OCCUPANCY CROU0 <br />R. 3 I (v , <br />NO Of DWILLING UNITS <br />1 <br />BUH.DING <br />S, rvVl <br />L•/�� <br />2. <br />G <br />$L 7�OI BEUG t. F. <br />I( ITf.-9 <br />43? s. - <br />NO or SIOPIES <br />I <br />MAX OCC LOAD <br />5 <br />PIUMBING <br />FIRE ZONE <br />.--- <br />HASE MENT <br />ITT DROOMS <br />3 <br />FIRE SPRINKItRS <br />REQUIRED <br />YTS <br />MECHANICAL <br />APPROVALS <br />RY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHICK LIST <br />PENALTY <br />SEC 1tC 31R11 <br />2 BUIIDINGPIANS <br />TOTAL <br />n <br />�� <br />) FIRE HYDRANT <br />A FIRE PROTECTION SYSTIM <br />5 GRADING I M-AVAIION A (I I ARINGiGRUBRING <br />PERMIT VALIDATION <br />WIZEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />6 DRAINAGE <br />7 INVIRONM[NTAt IMPACT STATEMENT <br />8 HEAITH IIISIRICT <br />APPI ICAIION ACC BY <br />B <br />PLANS CHECK[D BY <br />Nwm <br />APPR TOR ISSUANCE BY <br />L. • o <br />J <br />f] <br />91-19 <br />