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,�,E�ro�,� ApPLICATION FOR ���,�„ <br />°�^�°F �,ONSTRUCTION <br />everett PE RM IT e <br />DEPT OF COMMUNITY DE\'EIOPMENT $ERVICES <br />CITY HALL 259�8745 <br />EVERETT, WA9B701 �COMBINATION ❑ BUILDING ❑MEtHANICAL ❑PLUMBING PERMIT NO. <br />OWNlR MAlt.1DON[SS CIlS ZIP PHONF <br />xL.►oacy �� • z rrisl „►a-D i�'!� W k.{G� �ao aL�n o»s,c�•n 9Kzo3 �Sri—G ��/ <br />�NCMIi1CiOR0[514u10. MML�ODRISS fliY ZIP PHONE <br />GlNINM COMNAfi00. MAII ApOR65 CIIY ZIV PHON[ lIC[NSf 1 <br />�' S � � F <br />n�i(luhlUl CO'+iRnCiON MAII �OOP(55 ❑t1 LIP pMONF tICENS[ Y <br />PIUNPInG CONINACIOH M�II AppPfS$ CIiY ZIP pNONf IICEHS[ / <br />L1w55 04 NONK ,—,/ <br />❑NEW ❑ADDITION ❑ALTERATION Lrf}tEPAIR ❑DEMOLITION ❑FENCI ❑$IGN ❑GARACE ❑BUILDING REIOGTION <br />vnivnn/n-�n�o�i woar„ <br />1 '{[YJ � . <br />C <br />lI CAl 06LNIPI ION O{ 1'0.0P[ RiY ISHO�cN P! lON' ON Ai 1AC1110UR COPII S) <br />iot _ mocc _ or <br />nUnulss <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />flATMTUB <br />LA\'ATORY O'�'ASH flA51N1 <br />SIIOW(R <br />Al1CHfN SINA F UISP <br />DISWASMLR <br />I AU��'DN\' TNAY <br />CIOiHLS K'ASMFR <br />\YAIFR HfAi[R <br />UHINAL <br />f)NINRINC fOUN7AIN <br />FIOUN DNAIN <br />VANUAI f1NEAKCRS <br />ROUf DHAINS—RAINLEADFRS <br />SINK 6E R\9CE —NAR. [ TC 1 <br />USf ZOM1'L <br />TYPF Of COti! <br />SIZt OF HIDG <br />FINf ZOu[ <br />TOTAL FEE <br />STRE[1 5[TIIACK <br />lOT ARCn <br />OCCUPANCV GftOUP <br />r+o or SToai[s <br />[IAS[MEN7 III DHI <br />APPNOVALS <br />1 fNVIHONMt4TAL CMfCK LIST <br />7 OUILOIYG PIAM1l <br />7 fBE MIUHANT <br />1 FINE PROTLC110N SYSTEM <br />5 GNAUINGiL%U\'�71ONECLfABINCILNUNflING <br />6 DRAINAC[ <br />7 FNVIHONAIENTAL IMPACT STATfMEN: <br />B HEALTII OISiRICT <br />i <br />:[AN <br />FEE <br />5f <br />VAUNI $I7L <br />❑YFS ❑NO <br />Np Of O\VfLLING UNI75 <br />n�nx ott ionn <br />!Y � DATE <br />APPlICA710N ACC BY PUNS CMECKED BY I APPft IOR 755UANCE HY <br />9.7-; 9 <br />I HEREBY CtRTiFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TH[ SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THF GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PE ORMANCE OF Cf�NSTRUCTION. <br />s�c��tue f ONiRMTOH�7R�4�IIHOR1266ACFNT DATE <br />NO. TYPE OFEQUIPMENT <br />AIR CONO UNIiS—M P U <br />REfHIGFRATION UNITS—H P EA <br />BOLL[NS—HP U <br />GA$ fIN[D AC UNIT$—TONNAGE EA <br />fONCED AIR SYSTEAIS—f1 T U M EA <br />N'ALL HFATENS-17 7 U M <br />UNI7 MfATfRS-01 U M <br />CLOTHE$ ORYtRS <br />VLNIIUIION FAN <br />RANGfNOOD <br />AIR HAM1OLING U� <br />S70Vf ��'i�_ <br />M[TA1 FlREPUC[ <br />PEIIMIT <br />iOTAI FFE <br />I fEF <br />FFES <br />. Z6�'Z <br />� <br />f <br />f <br />PIAN CNECR FEE <br />RCCEIPT NO. <br />V FEE <br />owioinc s <br />PLUMIiInG <br />�1f ( HANIUL <br />OTH[R <br />PkNAL7Y U��� <br />SEC 1011al <br />TOTAI <br />�FRMIT VAIIDAiION <br />\YNfN PROPERIV VALIDATFD (IN THI$ SPACE) THIS IS YOUk PERMIT <br />oU <br />sa <br />