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IM EBRTBIRRA <br />CITY OF <br />APPLICATION FORS <br />ZONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-6745 <br />EVERE7T, WA9B201 ❑COMBINATION ❑ BUILDING rJMECHANICAL ❑PLUMBING PERMIT NO. <br />OWNER MAIL AUDMISS CITY zlr PHONE, p17,kn,7 <br />'7af <br />r L.'e %.I_ t 1 lT,.In <br />CkMERM CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br />MAIL ADDRESS CITY LIP PHONE LICENSE B <br />MICNANIUICONIMCIOR r. �, 10"L ' niG•r oFh •v,lydr %' E1rk,I Ir,,Y0 /f )n QV'r 9 "iS/•7 Q/AO <br />ly• . l <br />MAIL ADDRESS CITY 21r PHONE <br />-tip <br />I1C VLIX 1 <br />E�13K I - <br />CLASS Of WORK <br />®NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE 0BUILDINCRELOCATION <br />VALUATION Of WORK <br />1 -)18q <br />DESCRIBE WORK <br />I <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />rlloroyED Dr BUILOINc <br />c.: <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 />IECAI DESCRIPTION Of PROPERTY ISHDWN BELOW OR ATTACH TOUR CUPIISI <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT BLOCK _Of <br />TO VIOLATE OR CANCEL THE PROVISIONS OF <br />GIVE AUTHORITY <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />y �j <br />IDES ADDMFL <br />r or L Eve CJeL_fF <br />MECHANICAL <br />PLUMBING <br />FEE <br />TYPE OF FIXTURE <br />FEE <br />NO. TYPE OF EQUIPMENT <br />NO. <br />AIR COND UNITS -MP EA <br />WAT10. ClOSIT IIOVETI <br />REFRICFRATION UNITS -HP EA <br />BA'HTUB <br />flUILf RS-HP EA <br />LAVATORY IWASH BASINI <br />CAS FIRED AC UNITS -TONNAGE FA <br />SHOWER <br />IORC(D AIR SYSTEMS- B l U M EA I O <br />KITCHEN SINK L DISP <br />- <br />WALL HIATERS-BTU M <br />DISWASHER <br />UNIT Mf ATERS-BTU M <br />LAUNDRY TRAY <br />VE COOLERS <br />CLOTHES WASHIR <br />RYIRS <br />WATER HEATER <br />N FAN <br />URINAL <br />OD <br />DRINKING FOUNTAIN <br />MUNIT- <br />ING UNI T- CFMFLOOR <br />DRAINVACUUM <br />BREAKERS <br />BE I DRAINS-RAINLFAOFRS <br />EPLACE L CHIMNEYSINK <br />ISF RVICI-BAR. LTC) <br />_ <br />3k <br />O <br />In <br />FUB TOTAL F y Do <br />PERMIT B <br />SUB TOTAL <br />RRMIT <br />S <br />TOTAL FEE 1 0 <br />IUTAL FEE <br />PLAN CHICK NUMtlIR PLAN CHECK FEF <br />RECEIPT NO. <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SE IOACK <br />F!F <br />USE ZONE <br />LOT AREA <br />VACANT SIZE <br />fits <br />VALUATION <br />II! <br />OYES ❑NO <br />TYPE OF CONST <br />OCCUPANCY CROUP <br />NU Of DWELLING UNITS <br />BUHDING <br />S <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC IOAO <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />IILOKOOMS <br />FIRE SPFOKLIRS <br />MECHANICAL <br />f1YFS FIND <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PFNAL7Y <br />UBC <br />SEC )DRBI <br />Z BUILDING PLANS <br />TOTAL <br />EEE <br />.in <br />1 FIRE HYDRANT <br />A flRf PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPIRLY VALIDATED TIN IMIS SPACE) THIS IS YOUR PERMIT <br />- <br />S GRAUINGIULAVATION L CLIARINGIGRUBMING <br />h DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATI� CC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE By <br />9.1 79 <br />