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the EYBEOnRil APPLICATION FOR �Y�re„ <br />OILY OF CONSTRUCTION <br />everett PERMIT e <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 ,�.�/ <br />EVERETT, WA99201 IJCOMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OW NtR PHONE <br />MVI ADURf SS CIl1 LIP <br />G la���s fYEJ\.7; ps7- VL-1 <br />ARCHIOC10R DISKNIR P MAIL ADDRII3 CITI ZIP PBONF <br />ADORE <br />n^ INTONE <br />CENSE IF <br />/�-/� '�J•.?,Ppi' <br />PIUMBINC CONTRAC70K MAIL ADDRESS CIII 10. PHONE LICI15II <br />❑NEW ❑ADDITION ❑ALTERATION P EPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />S'ALUAI ION OF SWORK <br />�Gd-D <br />DISCRIIII NORK <br />%?2o�J./J�s,� .-nt..G�uGI�,,✓�.r,.� s!.✓Ic� �K�li�' u-z- t.,z.14'r�fiS . /tu2/e: Nn _ �ttr1<<- lm-,1'� - <br />PROPOSE 01-SE OF Bw LNG <br />-" <br />I HEREBY CERTIIY THAT I KAVAtAD AI EXAMI T AP- <br />I'LICATION 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 />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 />SIGNATURE Of CONTRACTOR OR AU 1)ICEb AGENT OAT[ <br />jO\ - / <br />X Arz`S OOOCCC44uiiii/// <br />IIGM DISCRIPTION OI PROP1RIy DHOSYN BUOA OR ATTACH r :a roan Sr <br />LOT BLOCK 11LML1_ OF �w,� �� <br />• / <br />NUN All11R155 /i <br />PLUMBING <br />MECHANICAL C/ <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />T <br />%%ATER CLOSI7 (TOILET) <br />AIR COND UNITS-H P EA <br />J <br />BAIHTUB <br />REFRIGERATION UNITS —HP FA <br />LAVATORY (WASH BASIN) <br />BOILERS —HP EA <br />SHOWER <br />GAS FIRED AC UNITS —TONNAGE EA <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS—B T U .%I F \ <br />DISWASHtR <br />WALL HEATLRS-07U M <br />LAUNDRYTRAY <br />UNIT HLATERS—BTU M <br />/ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HE <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C f M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />MFIAT FIRIPIACL A CHIMNEY <br />SINK (SERVICE —BAR, ETC) <br />SUB TOTAL <br />SUBTOTAL S <br />PERMIT <br />S <br />PERMIT f <br />TOTAL It[ <br />S <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />Si RIFT SEIRM-K <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PUN <br />III <br />CHECK FEE <br />RECEIPT NO <br />USE ZONE <br />L07 ARIA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />!F[ <br />TYPE Of CONST <br />(OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />1 <br />SIZE OF BLOC <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />OASFMFNI <br />a1pR,h,mS <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 LNVIRONMEN'AL CHECK LIST <br />PENALTY <br />URIC <br />SEC. SON.) <br />2 BUILDING PLANS <br />TOTAL <br />— <br />FIRE HYDRANT <br />A FIRE PROTECTION SYSTEM <br />5 GRADINGIIXCAVATION A CLI ARINGICRUBBING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />b DRAINAGE <br />7 INVIRONMENIAL IMPACT STATEMENT <br />B HIALTH DISTRICT <br />APPLICATION ACC By <br />PUNS CH(CQD BY <br />APPR FOR ISSLA(I IT <br />91.79 <br />