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. , <br /> A,PPLICATION FOR ���n„ <br /> �TME� "� ' �,ONST�tUCTION .� <br /> everett PE RM IT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES . <br /> CITY HALL 259-0745 �� <br /> EVERETT,WA971201 ��OMSINATION ❑ SUILDING �O' �MECHANICAL ❑PLUMlINC PERMIT NO. <br /> OWNE)R \ M��I�UOMIS$ .. . CIIY 21P . PXONF -. <br /> ,'J ;'� . 1\.'_�,��, , C�c � ' .�.1�" O/.�'! )�!'--. .�•/•� :.�Y: � �.:J."' '"� _-� � '_(j-% / � . <br /> ARCNR[ROIID[SIGN/[R ' MAR�f.ORFSS UfY ZI� �NONF <br /> '�,..:./�.'-) ./ (:��(. J(i � <br /> GENEMIfOMR�CIOR MAIIADDRESS �ITY ZIP PHOHE U[ENSEI <br /> `��)�. �i� -L. <br /> M[C��ANIUI CONLXMIOF M�II ADDIlE55 CIIY LIP PHONE IICENSE� <br /> ��l "� 1 ' �� <br /> PW��PIrvG ONtll�[i011 MSILADDRL55 CIIY 21P PNON[ IiCFN5E1 <br /> CU55Oi WOLLK <br /> ❑NEW ❑ADDIiION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑`ENCE ❑SIGN ❑GARAGE ❑BUILDING RELf/CATION <br /> W W�TION Of N'OM[ i <br /> � <br /> DfSCRIBE WOIU( <br /> I <br /> raoros[oust ar eumm�c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• I <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL ` <br /> LFWI OESCRIPtION Oi PIIOPlR1YISNOWH 9ElOW ORAtT�tN fOUll COPIf51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1HI5 TYPE <br /> OF WORK WILL BE COMPLIED WITH WHE7HER SPECIFIED HEREIN <br /> l01�BIOCk��Oi OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO , <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER 57ATE OR LOCAL LAW REGULATING CONSTRUCTION � <br /> OR THE PERFORMANCE OF CONSTRUCTION. � , <br /> SICNATURF OF CONTRACTOR OR AUTMO Y[D AGENT D�TE / � � . � <br /> i� �r Jr <br /> ioe.00ncss „i" .' - , �" � � � � . <br /> . �� <br /> X �_r'�y.� �- / <br /> �; <br /> 7lUM�ING MFCHANIC�I� <br /> NO. iYrE OF FI%TU�E FEE NO. TY�E OF EQUI�MENT iEE <br /> WATER ClOSFT�IOLIETI AIR CONU.UNITS—H P.EA <br /> B�TMTUB 0.FFRIGER�TION UNITS—X.P.F� <br /> , IAVATORV�WASM BASIN) DOIlERS—MP EA - � <br /> � SHOWER LASiIRED At UNITS—TONNAGEEA <br /> � KITCHFN SINK 8 OISP FORCED AIN SYSTEMS—B.T U M FA <br /> DISWASHFR WAIL ME�tERS-8 T U M <br /> , UUNDRV TRAY UNIT HEAiERS-B T U. M <br /> � CLOiHES WASHE0. FVAPORATIVE COOLERS �' <br /> I <br /> � I WATfR MFATER CLOTNFS DRVER$ � <br /> ' URINAL VENTIUTION FAN <br /> i <br /> DRINKINC FOUNTAIN R�NGE HOOD , <br /> FIOOR ORAIN A10.H�NDUNG UNIT- . C F.M. � <br /> ! VACUUM BRF�KFRS / STOVE L��°"�" :6��.TSL��` u��C'� :' <br /> i ROOF D0.AIN5-NAINIEADFRS MFTAL LIRFPL�CE 8 CHIMNFY ' <br /> � SINK fSFRVICE-BAR.ETC 1 <br /> fU�TOiAI 3U�iOTAI � � <br /> ' R�MIT � rF�MIT � <br /> TOTAIiFE f iOTAIfEE � <br /> � SIDF YARD SETBACK STREET SETBACK RUR YARU SFTBACK iUN CH[CK NUMBER PLAN CNECK FEE <br /> ¢, FEE RECEIPT NO. <br /> . USE ZONE LOT ARfA VACANT LiE IFES � \'AWATION i!F <br /> OYES ONO <br /> TYPE Of CONST OCCUPANCY GROUP NO.OF DWEILING UNITS <br /> ' BUIL�ING f <br /> SIZE OF BIDG NO.Oi STORIES MAX OCC.IO�D <br /> PlUM81NG <br /> FIRF 20NE BASEMENT HlDROUMS pEQU10.FDKLERS MECHANIUI <br /> OYFS ❑NO <br /> AM�OVALS �t DAit UTHFR <br /> 1 FNVIRO4MFNTALCHFCKlIST PFNMtY U.BC. <br /> SFC JON+1 <br /> 3. BUILOINC PUNS <br /> TOTAI <br /> 7 fIRE HYOR�NT <br /> � fINF ►ROTECTiON SVSTEM ►EIIMIT VALIDAiION <br /> WHFN PROPERLY VAl:OATED ItN THIS SPACE)TH1515 YOUR PFRMIT <br /> 5 G0.ADINGk%CAVATIONBCLFARINGIGRU9flING <br /> 6 DRAIN��E <br /> 7. ENVIRONMENTAL IMPACT STATEMENT � <br /> ! HFALTH DISTRICt <br /> �PiIICATION ACC. BY PLANS CHECKEO BY APPR fOR ISSUANCE BY <br /> 41�79 <br />