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, <br />NERFE,-goo k 'PLICATION FORcm OF <br />„ <br />everett CONPSERMITTION e <br />DEPT OF COMMUNITY DEVI EOPME NT SERVICES <br />CITY HAIL 259-874S <br />EVERETT. WA9R2B1 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />O t1A11 AU11x1 tt (Ill /Ir PHONE <br />5�70fr �y✓as ubank. Co'ISC lr �W`Yy <br />ME HIII(7 ORDI SICNIR All MIURItl Iln lln PHONE <br />(11 At C(lIt%�OR <br />MAII M)URl tt <br />111) <br />ZIP <br />PHONE <br />IICFNSI / <br />/J <br />/"Ul.E7.IDr.Wo {�in.c <br />az92Fs�iiay 99 <br />FO�o�/os, <br />9�Ozo <br />�y�•-.5a,�y <br />u,-��•,�tiE <br />tll( HANK At(ONIRACIOR <br />MMI AuuRltt <br />ITT\ <br />nP <br />PHONE <br />LICENSE <br />PIl t1PIN1.1 ONIRM TOR <br />MAIL Al)DRIN <br />I111 <br />ZIP <br />PHONE <br />LICENSE I <br />Ie I A11 "'INK <br />❑ADDITION ❑AITIRATION FIRE PAIR ❑DEMOLITION ❑Ef NCf ❑SIGN ❑GARAGE ❑BUILDING Rf LOCATION <br />\ Y 1 A] I(1N OI W (1MK <br />f (o QUO c= <br />MINIM N011n, <br />rRl mnMULe nr BUn DIN- <br />1 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 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 />SIC.N RI Of CONIRACIOR OR AUTH )ZED AGENT DATE <br />I• / lIzza <br />i� <br />CELAt OttCRlrlloN of PROPIRII 6I10W1 AEION OR ATTA(H FOUR (OPIISI <br />I(11 `BLOCK OOo of _ •¢ 41AJ <br />5/ Ar <br />(� <br />TOP AUHRI tt <br />RUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />It[ <br />NO. <br />TYPE Of EQUIPMENT <br />fEE <br />WATIR CLOSE I(TOFFEE) <br />AIR(OND UNITS -IFP EA <br />BATHTUB <br />RIIRI(.IRATIONUNITS-HP IA <br />I AVATORY(WASH BASIN) <br />ROIIIRS-HP EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE FA <br />KITCHENSINk{ DISP <br />IOR(ID AIR SYSTEMS -BTU MFA <br />DISWASHIR <br />WALI IIf ATERS-BTU M <br />LAUNDRYIRAI <br />(JNII IOMIRS-fl 11) M <br />CLOTHIS WASHER <br />ISAP(`RAtIVf COOLERS <br />WATIR HEATER <br />CIOTMS DRYIRS <br />URINAL <br />%'I NI TI AT ION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR NANDI ING UNIT- C I M <br />VACUUM BREAKERS <br />S I OS'I <br />ROOF DRAINS - RAINLI ADL ITS <br />M11Al IIRIPIACI A CHIMNEY <br />SINK (SERVICE -BAR. ETC 1 <br />SUB TOTAL <br />SUBTOTAL { <br />PERMIT <br />{ <br />PERMIT { <br />TOTAL FEE <br />f <br />TOTAL FEE { <br />S IDF YARD SI TBACK <br />STREET "TRACK <br />REAR YARD SI IBM K <br />PUN CHICK NUMBER <br />lFlil _ :; <br />d I <br />PLAN CHECK FFE <br />iff RECEIPT NO <br />USE ZONE <br />LOT ARIA <br />VACANT SITE <br />❑YES CNO <br />FEES <br />VALUATION <br />FFE <br />IYPI Of CONST <br />OCCUPANCY CROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE Of BLDG <br />NO Of STORIES <br />MAX OCC IOAO <br />PI UMBING <br />FIRE ZONE <br />BASEMENT <br />HI OR(1pMt <br />FIRE SPRINKLERS <br />RFQUIRID <br />ITYIS ETNO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 FNVIRONMENTALCHECK LIST <br />PINATTY <br />UBC <br />SEC TOAaI <br />Z BUILDING PLANS <br />T FIRE HYDRANT <br />TOTAL <br />/ FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHIN PROP) FLY VAI ILIAT! D (IN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADING)! X(. AVAI ION A Cl f ApING.r(;RUNBING <br />6 DRAINAGE <br />7 ENVIRONMFNTAI. IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />(, . G <br />9.179 <br />1 <br />1 <br />