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, <br /> ApPLICATION FOR ���,�„ <br /> �nE�'°'"" �ONSTRUCTION e <br /> everett PERMIT <br /> DEPT. OF COMMUNITV DEVELOPMENT SERVICES . <br /> CITY HALL 259�87�5 <br /> EVERETT,WA9B:01 ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> O1yq� MAII�ODX65 ❑iY ZIP YHONE <br /> ��,�;,,� G cr'.,(� 2�aSS �rwAv►eW e�.� E�e�t- 98�03 3 3�__ — <br /> �RCNITEI'T 00.OESIGNER MAIUOORE55 CITY ZIP PMONE <br /> GfNfR�LCONIRACT00. MAllAU0A65 UTY 21P PNONE IICFN5E1 <br /> AUCNANIULCOv10.AC10P MAllA0DRE55 CI1Y lIP PHONf IICENSL/ <br /> PIU��NVG CONiPAC10R MMl A�OPl55 CIIY ZIP VNOME LICENSF I <br /> CU550f WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE BUILDING RELOCATION <br /> \'AWel10N O�H'ORk <br /> t 1 1 <br /> OISC0.1 KONK �bl,l� lJ '� � `l <br /> R �� �v� r_ <br /> rRoros o usF oi xmiou+c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> «G�l DISCRIPIION OI P0.0PlNiYISIION'N BIIOW OR�11ACN fOUN COP�ISI PROVISION$OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> IOiI�BIOCK�04 OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW RECULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONTRACTOR OR AUTHURIZED AGENT DATE <br /> ioxnouaiss ,.,� x ��(� b�+ <br /> �AN AUIeW 8�u • <br /> PWMSING MECHANICAL <br /> NO. TY�E OF FI%TURF <br /> FEE NO. TY�E OF FQUIIMENT FEE <br /> WATFR ClOSET ITOIIET� AIR COND UNITS—NP.EA <br /> REFRIGERATION UNITS-M P.E� <br /> flATHTUB <br /> IAVATORYIWA$NBASIN� BOILERS-NP FA <br /> CAS FIRED AC UM1�TS-TONNAGE EA <br /> $NOWF0. <br /> FORCFD AIR SYSTEAIS-B T U M FA <br /> KITCM[N SINK 8 DISP <br /> WALIMEATFNS-OSU M <br /> DISW�SMER <br /> UNITN[ATERS-BTU M <br /> UUNORV THAY <br /> f\'APORA7IVE COOLERS <br /> ClO7HE5 wASNFR 'CLOTNES DRYFRS <br /> WATFN MEATFR <br /> VENTILATION FAN <br /> URIN�� <br /> D0.INKINC FOUNTAIN RANGF HOOD <br /> iIOOR DRAIN AI0.HANDLING UNIT- C.F M <br /> VACUUAI fl0.FAKFRS STOVE �!]� <br /> NOOf �RAWS-RAINLFADEkS .'.1ETAL FBFPLACF 6 CNIMNEY <br /> SINK ISERVICt-BAR.E1C 1 <br /> SU/TOiAt s <br /> SU!iOTAI <br /> �FRMIi f �E�MIT � <br /> y TOTAL iEF s <br /> 70TA1 FfF <br /> pIAN CHECK FEE <br /> SIDF VARD 5[TOACK STR[FT SCTIfACK R[AR YARD SFTOACK PUN CN[CY NUM1IOfR FFE RECEIPT NO. <br /> USk ZONE LOT ARFA yAGNT SITE FF[f - VAIUATION FFE <br /> OYFS ❑NO <br /> TYPE OF CONST OCNPANCY GROUP NO OF�WELIING UNITS <br /> BUIIDING S <br /> SIZE OF HLOG NO.OF STORIES MAX OCC LOAD <br /> PlUM01NG <br /> FBE ZONE BASfMFNT I7lUNOOM1IS RFQU RE'DKIERS ��ECHANIUI <br /> f7YES ['NO <br /> A►MOVALS �T D�iF O7NfR <br /> 1 ENVIRONMFNTAI CHECK 115T U B C <br /> P[NALTY $EC 7UNa1 <br /> a euiiou+c ruNs <br /> TOTAI <br /> J FIRE NY�RAN7 <br /> � FIFE P0.0TFCTION SYSTEM tFRMIi VAlIDA710H <br /> WMkN P0.0PfRLY VAl10ATED��N TMIS SPACF�THIS�S YOUR PEHMI7 <br /> 5 GNA�INCIf%UVATIONBCLkARINGIGRUXNINC <br /> 6 DRAINAGF <br /> 1 fNVIRONMfNTALIMPACT5IATEMENT <br /> ! MEALTH DISTRICT <br /> APPLICATION ACC.BY PLANS CNFCKED BV APPN fOR ISSUANCE BY <br /> V <br /> c� <br /> 9�1•79 , <br />