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� <br />P <br />APQLICATION FOR -- <br />''`' ,;""'�" CvNSTRUCTION <br />eVerett PE RM IT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALI Z59�8745 <br />EVERETT, WA99707 ��OMBINATION ❑ BUIIDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />everetl � <br />e� <br />. GFNERM CONTRACIOR AUIL A��RLA C�1Y 21P PMONE LICEN$[ I <br />� d� Lf - <br />MECMANIUI CONiR�CTOR M�II ApDRI55 CIl\ /IP PMONF iICENSE � <br />PIUMBING CONTRACTOR MAII AODRf55 CITY ZIP PHONE IICENSE 1 <br />[IASS OF WORK <br />�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN �GARAGE ❑BUILDING RELOCATION <br />\'AWATI OF WORN � <br />� �Ol.' � I <br />DFSCRIfl[ wOPK � � <br />x�D <br />use ov eunou+c <br />IEGAI 0lSCRIPTION OF.,PR�O,P�E/RTY ISNOWN FFIOW OR �iTACN I <br />ioaa�C eix�Sd .1 or �✓ ��ETY ' <br />�OB <br />�LUM/ING <br />. NO. TY�E OF <br />� WATERCLOSET(TOLIE <br />, BATHTUB <br />i IAVATORVIWASH BAS <br />SHOWER <br />fy _ KITCHEN S�NK 6 DISP. <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAI <br />VACUUM BREAKERS <br />ROOF DRAINS-RAII <br />ETU <br />SETBACK <br />ZONE IOTANE� <br />� 'L <br />OF_CQNST. OCCUPANCY GROUP <br />Y �u M -1 <br />OF 8��. _ � NU. Of �ORIES <br />AMROVALS <br />' 1. ENyIRONMEYTAI CHECK LIST <br />' 2. BUILOING PIAN$ <br />� 3. FIRE HYDRANT <br />, l FIRE PROTECTION SYSTEM <br />5. GRADING/FXCAVATION 8 GLEARINGIGRUIfHING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATfMENT <br />E. HFALTH DIS•?;(.: <br />APPLIUTION ACC. 9Y PUNS CNECKk� fiY <br />V� <br />91-i9 <br />I HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS AP- � <br />— PLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT ALL <br />COPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS 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 RECULATING CONSTRUCTION �. <br />OR THE PERFORMANCE OF CONSTRUCTION. , <br />SIGNATURE OF CONTRACTOR OR AUTHOR2ED AGENT DATE � <br />FEE <br />sl I <br />REAR YARD SETHACI <br />VAGN1 $ITE <br />OYES L�?N6 <br />NO OF �WELLING L <br />MA%.00GtOAD <br />FIRk SPRINKLfNS <br />REQUIRED <br />OVES f5t16 <br />!Y DAiE <br />APPN f OR �SSUANCE ItY <br />MECHANICAL <br />NTT- <br />AIR COND. UNITS-H.P. EA <br />HEFRIGERATION UNITS-H.P. EA <br />BOIL[RS-HP. EA <br />GAS FBED A.C. UNITS-TONNAGE EA <br />FORCED AIR SYSTEMS-B.T U. M <br />WAII HEATERS-BS.U. M <br />UNIT HEATERS-PS U. M <br />E\'APORATIVE COOlERS <br />CIOTHFS DRVERS <br />VCNTIUTION FAN <br />RANGEHOOD <br />AIR MANDLING UNIT- CF M. <br />SiOVF <br />METAL FlREPLACE 6 CHIMNEY <br />SUliOTAL � <br />PFRMIT f <br />iOTALfFF f <br />PUN CHFCK FEF <br />fEE . p RECEIPT NO. <br />O � <br />v� <br />VALUATION FEE <br />9UIlDING 3� � <br />PLUMNING <br />MECMANICAI <br />OTHER <br />PENAITY U.fl.C. <br />$El. JOJ(a) <br />TOTAI <br />PE�MIT VALIDA710N <br />1VMEN PROPERII' VALIDATED (IN Tf115 SPACE) TMI515 YOUR PERMIT <br />