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,. <br /> � , <br /> APPLICATION FOR <br /> �, everett 1 CONP RMITTIO� _ !e <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> - CITY HALL 259�B715 <br /> EVERETT,WA98201 ��OMBINATION m BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> - OWNfR �nell AODNFSS ❑tY IIP PNONF <br /> ' I,�/A. l�/e 6eF 7�3o O/v� o; c Di� vP �"r/ci et� �.��� ss-r- �s�9 <br /> �R�ROIIDISIGN[p MnIIADDRISS-7 C�TY 21P PNONF <br /> CENGM CONIRACTOR MML ADDROS ULY 211` VHONE IICENS[1 <br /> MFCM�NIUI CONiR�CiON MMl�DDI1F5$ CI1Y LIP PNONF UCENSE I <br /> r PIUUpIM1f,CONiN�CiOR M�II ADDRfS$ ❑IY ZIP PHONF llC[NSF I � <br /> QA55Of WOPK <br /> ❑NEW ❑ADDITION ❑ALTERATION I�REPAIR ❑DEMOIITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDINGRELOCAiION <br /> V�IUniIONOf WONt ^ l' <br /> � '(�l e� v � <br /> �ISCN19!WORK <br /> U <br /> 1`ROPOSFO�SF OI BUilOi�+G I HEREBY CERTIFY THAT I HAVE READ A!JD ExAMINED TNIS AP- <br /> � PLICATION AND KNOW THE SAME TO BE TRUE I.ND CORRECT ALL <br /> iEe.i oesea�ru N Of PqOFINIV�SMOWN qFIOW OR�ilAC1110UN CO%FS) PROVISIONS OF lAWS AND ORDINANCES GO� ERNING THIS TYPE <br /> / fyp OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> wt/Y�eioc�_�or P � OR NOT. THE GRANTINC OF � PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOUL LAW REGULATINC CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. � ��� 3 <br /> SIGN�iURE OF CON7RACTOR OR AUTH00.1ZFD ACFNT DATF <br /> IOP�UORFSS y �� 7 � <br /> Q. Q / C /� / V ' I� <br /> ►W M/IHG MECHANICAL <br /> NO. TY�E OF FI%TURE FEf NO. TY►E OF EQUI�MENT FEE <br /> WATERCLOSET�T011E71 AI0.COND UNItS—MP EA <br /> B�TNTUB REFRIGFNATION UNITS—M P fA <br /> UVATORY IWASM BASIN� POILERS—��P U <br /> SNOWFR GASfIREOAC UNITS—TONNAGEfA <br /> KI7CMEN SINK 8 OISP fORCf D AIR SYS7FM5-9 T U M F� <br /> DISWASHFR W1LlNkATERS—BTU. M <br /> UUNDNYTRAV UNITMfA11R5—BTU M <br /> CLOiMES WASHLN fVAPOkAiIVF COOlERS <br /> WA7ER NEATCR CIOiHES DRYENS <br /> URINAL VFNTIIATION fAN <br /> � DRINKING FOUNTAI:J RAN(;E NOOD <br /> FIOON ORAIN AIR HANULINC UNIT— C P M <br /> V�CUUM flRF�KERS S10VF <br /> ROOf ORAINS—NAINLEADERS METAI RRFPUCF b CHIMNfY <br /> SINK�SERVIC[—flAR,EiC I <br /> SU/iOTAI SU�TOtAI f <br /> ►F�MIi f ►F�MIT ! <br /> i07�lIEE � TOTAIF[E f <br /> SIUf VARD SCT9ACK STN[CT SCTItACN RUR VARD SF i6ACK PUN CH[G:NUMBER PUN CNECK fEE <br /> FEF RECEIPT NO. <br /> US[ ZONL lOT AHU y���NT SIT[ ' <br /> ❑YES ❑NO iFES ���UA710N iEF <br /> IVPE Of CON57 OCNPANCY GROUP NO OF DWfll ING UNI75 <br /> BUILDING f v <br /> SRE Of BLUG NO O�STORI[5 MA% OCC IO�D <br /> PWAIOING <br /> f10.E ZON[ BASEMfNT 17tUROOMS ��R� SPRINKLLRS <br /> NfQU'-?[D M[CHANIUI <br /> fIYFS ❑Nb <br /> �HIIOVAIS �Y DAT[ pTHfR <br /> 1 fNVIRONM[NTAL CNFCK LIST U.O.C. <br /> PINALTY $EC. N1Hd) � <br /> 2 BUILOING PL�N$ <br /> J FIRE HYDM�NT TOTAL I � ^� <br /> � FINF PROTECTIOM SYSTEM �[RMIT V�IIDATION <br /> WHEN PROPFRLY V�LIOATfD(IN THIS SPACE)THIS IS YOUR PFRMIT <br /> , 5 CNADINGIlKCAVATIONbCIlANINGIGRUBflING <br /> � <br /> 6 DRAINAGE <br /> 7. FNVIRONMENT�IIMGTCTSTATEMENT <br /> E HF�LTN DISTNICT <br /> APPLICATION ACC BY PUNS CMFCK[D BY APPII fOR ISSUANCF BY <br /> 41-79 <br />