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, _ , <br /> P�'PLICATION FOR <br /> fMEwqmn ' �,pNSTRUCTION �e � <br /> cin or <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICES . � <br /> CITY HALL 259-8715 ,.��� <br /> EVERETT,WA9�701 ��pMSINATION ❑ sUILDING LJMECMANICAL ❑PWMtING PERMIT NO. � <br /> OWNI)R M��l�OON6S��J ' CILY ' ZIP i�� .� �NONF —� �y� ' � � . <br /> .�✓ 1 . � ._�':/� '✓y.� - �1��%���� ��/� L�'t�c�. �/.� ..'�!�'� .� _i-! -^� _i ... �_ �J� . _ . <br /> L � — Y <br /> AR[HIT[CTOIIOELLNt � ) M�Il�D01165 pTY ZI� r110Nf � <br /> ��:�C� ) -/ ���s/ C�" ( � <br /> GFNFMI fOH111�C10R M�II�DDRESS CITY 21Y PHONE IICENSF� � <br /> � YL fc�.� <br /> ME[M�NIUI CONiR�CfOR �UiUDDI1F55 C11Y 11Y PHONE U[ENSE� . <br /> / � G li_... -� <br /> PWMPINL COMIR�CIOR MAII�000.ESS CILY ZIP PHONE LICENSE/ ' <br /> l�—_' <br /> CI�5501 WONI( � <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN L�GARACE ❑BUILDING RELOCATION <br /> V�IUAiIONOi WORK � <br /> f <br /> �FSCRIBE WORR <br /> rAoroseo us�or eunou+c I HEREAY C`RTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> PLIGTION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL ' <br /> IEG�I OESCIIIPiION OI FIIO�FRL"ISNON'N pFLOW OR�TT�CM fOUP COPIE51 PROVISIONS OF LAW$AND ORDINANCES GOVERNING?HIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ioi eioca_ov OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> � GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF � <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> � - OR THE PERFORMANCE OF CONSTRUCTION. /// <br /> SIGNATURF OF CONTRACTOR OR AUTHOqZ[D AGFNT DATE /� � /' � � <br /> Pi !J �1��t <br /> r � ioe.00xtss .���� ;;_ ����� � ' <br /> r I X <br /> •�.�..��� � ►IUM�ING M[CMANIC�I� , . � <br /> � NO. TYrE Of i1XTURE FEE NO. TY�E OF FQUI�MENT FEE <br /> � � WATFR CLOSET ITOLIET� AIR COND UNITS—H P.EA <br /> B�TNTUB RFiR�GERATION UNIiS—NP EA i <br /> i IAVAIORY�WASN BASIN) BOILERS—MF EA <br /> � ; SHOWFR GAS fIpED A.0 UNITS—TONNAGE FA �, <br /> � KITCHEN SINK L DISP FORCFD AIR SYSTEMS—B T U M FA <br /> � DISWASMEN WALI HE�TERS—BSL M � <br /> � UUNDRY TRAY UNIT HFATERS—B T U M <br /> � CIOTMFS W�SHER EV•\PORATIVF COOIERS <br /> WAiER HFATER CLOiHFS ORYFRS <br /> ' URINAL VENTIUTION FAN <br /> � D0.INKING FOUNT�IN NANGF HOOD <br /> F1000.�RAIN AIR H�NDLING UNIT— . C.F M <br /> VACUUM BREAKERS / STOVF L����`��^ /l` . ZZ^ �(t�%7 r ' <br /> ' ROOF DRAIN$—R�INIEAOERS MFUL FIRFPUCF 6 CMIMNFY <br /> $INK�SERVICf—BAR.ETC� <br /> I fU�TOiAI SU�iOiAl � <br /> R�MIT { HIIMIT • <br /> TOTAL�E[ t 70TA1 iFF • <br /> SIDF YARD SETB�fK STRFFT SCTBACK R[AN YANO SFTBACK PLAN CHECK NUMBFR PL�N CHECK FEE <br /> FEE MECEIPT NO. <br /> USE ZONE LOT ARE� y���NT SIIE '� <br /> ❑YES ❑NO IEES � VAlUAT10N iE! <br /> TYFE Of CONST OCCUPANCV GROUP NO OF DWFIUNG UNITS <br /> BUIIDINC S <br /> SIZE OF BLDG NO OF STORIFS MA% OCC IOAD <br /> PLUMpING <br /> FIRE ZONF BASFMFNT HkUROOMi �IRf SPRINKLERS <br /> RFQUIREO MFCNANIC�L <br /> ❑Yf5 ❑NO <br /> AM�OVALS �Y DAiF OTH[R <br /> 1 ENVIRONMEN1AtCMECKl15T pEN��TY U.BC. <br /> — scc wx+i <br /> 3 BUILOINC PLAN$ <br /> 7 flBF MYORANI TOTAI <br /> � FIRE PROTECTION SYSTEM ►EIIMIT VAIIDAiION <br /> WMEN PpOPE0.lY VAII�ATFD(�N THIS SPACEI THIS IS VOUR PERMIT <br /> 5 GNAOINGE%CAVnTION6CLfARINWGRUBR�NG <br /> 6 DRAINAGE <br /> 7 FNVIRONMFNTALIMPAQ STATEMENT � <br /> ! HFALTM DISTRICT <br /> APVLICA710N ACC BY PlANS CMFCKFD BY APPR FOR ISSUANCF BY <br />