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fMEwqn�n APP�'� ICATiON FOR .- _ ���,�„ <br />°�TM°F C(,��STRUCTION <br />everett PE RM IT e <br />DEPT OF COMMUNITY D:JELOPMENT SEkVICES <br />CRY HA! L 259-87t5 <br />EVERETT, WA9B20� ❑COMCINATION ❑ BUILDING ❑MECHANICA! ❑ViUMSING PERMIT NO. <br />OWNIR MAII�DOXl55 CILY IIP PNON[ <br />�'<<.� ,�'/a/( � S�b'" (i/ti,..�•c ✓� r✓t.•c7 <br />eI1C�11TECTOROf!•CtitR i,nsll�ODRf55 CIiY ZIP PNON[ <br />�� 't'C' �(� <br />GfNEN�ICONTPACI011 MNIAODRf55 CRY ZIP pHOMF E � C <br />C C �. f`Y�..c• � <br />�1 �� t::..) �o. zYiJ-'�"`S9' L`✓r. � cT TP2ui �S2- 15'�9 <br />��ICNAt+IUICOniR�fiOR MM1�000.F5S CI1Y tIP PNOMF �ICFNSEI <br />1`Il•��NISG [On1PA[ION Meil �DD0.[SS ❑ii ZiP PHONE IiCFMSE 1 <br />ClAS$ Of N'ONR <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑OEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />\'AIVAIIOti OI N/'O'Mt <br />f / _ I�l ( q rl <br />DISCM191 WORK � <br />��,�,....dK1;.-✓ <br />vaorosio ust or xunoi�c <br />1[L�l O[SCRIPIIOH Oi YROCIq1Y ISHOwq pFlOti ON niIACM fOUR COPlf51 <br />�o,�_a�«.�o� i{e,,�e� (� N-!Is <br />�/V 4L �tSPr.c% Al¢r <br />IOP eD0 <br />I a lS <br />►1UM01NG <br />NO. TY►E OF FIXiURE <br />\YAIi R ClOSET ITOLIETI <br />uvnTo,rtw.` _.-. . <br />Y.RCHEN SINN <br />�ISW�SHfR <br />I�UNORYiNA <br />C/OTMES WA! <br />WATER HFATf <br />URINAI <br />DRINKINL �O <br />FLOON ORAIN <br />VACUUM BRE. <br />POOF DRAINS <br />SINR ISERVI�E <br />D a �� <br />i'i,�G C l, <br />FFE <br />US[ ZONE l07 ARU y���NT 511[ <br />❑YES �HO <br />Typ ONST OCNPANCV GROUP NO OF DWfILING UNIT$ <br />�-,� z- -/ t <br />SIZf OI HL�G n0 Of $iORl6 MA% OQ LO�D <br />-� _ _ / .�— <br />� — 1 --�- I �_ <br />AC►�OV�If <br />1 [NVIRONMfN7AL CHECK 1151 <br />2 BUILOING PUNS <br />3 fip[ HYDRANI <br />� IIRE PROTLCTiC'I SYSTEM <br />5 GNADING�1%UVAIION6CLURINUCIIUBflING <br />fi DRAINAGE <br />7 [NVINONMFNTAL IMP�CT STATfMFNT <br />e NEAUH DISTqIC1 <br />ION �CC BV I PlANS CMLCKED BY <br />� �• <br />g.1 79 <br />/ � <br />Ce•_r�/:�f r ('l e xZ0 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION 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 REGULATINC CONSTRUCTION <br />OR iHE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE Of CONT0.ACTOR OR �UTHOR12fD AGFNT D�TE <br />X , %C C �!. ,, <br />MFCHANIUL � . <br />NO. TY►E OF EQUI/MENT <br />AIRCOND UNITS—HP EA <br />RFfRIGFR�TION UNITS—H F EA <br />BOILERS—H P EA <br />LASRNE�AC UNITS-10NNALEfA <br />WALINfATE0.5—BTU M <br />UNIT HkATERS—B 1 U M <br />EVAPORATIVF COOLfRS <br />CLOTHfS DRVfRS <br />VlNTI�ATION F�N <br />RANGFHOOD <br />AIP MANDLINL UNIT— C F M <br />STOVE <br />MFUI RREPIACE 6 CNIMNEY <br />fU�TOi�I <br />►EIIMIT <br />TOiAIiFF <br />ILCK NUMBEX <br />fE[ <br />i[[S <br />suuowc <br />PLUMOING <br />Mf CH ANIUI. <br />�� � D�TE � O7NF0. <br />APPN fOR 45UANll PY <br />Pk NAIiY <br />TOTAI <br />VAlU�T10N <br />UBC <br />SEC JOJ(�) <br />/.2'/-�iI <br />RFCFIPT NO. <br />►EIIMIi V�IID�TION <br />WNfN PROPLRLY VALIOAiED!IN TMIS SP�Cq THIS �S YOU0. PERMIT <br />f[E <br />