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Fill <br />-I <br />APPLICATION FOP Pe <br />FAT EYsrpreen CITY OF CONSTRUCTION 0 <br />everett PERMIT <br />OF PT OF COMMUNITY DEVELOPMENT SERVICES <br />r CITY HALL 2598745 <br />EVIRLIT.WA98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />ONNLY 1I0L AOIIRISS CITY ZIP PHONE <br />$ce-H- &km_--E1 , ,iLloA Mu1T,liT'E, Blvd EwicW- 9$a03 3KJ75�/5"� <br />v <br />CENIRAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE I <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE I <br />PIUMBINC CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />l� <br />L <br />❑NEYV V [V3ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION OFFENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />\'AIUAUON Of NORK <br />S 1500.00 <br />DISCRIHI NORK <br />PROPOSED UST Of BURDINc <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />t Coidtm e_e . <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />ITGA' DESCRIPTION OL PROPERLY (SHOWN BELOW OR ATTACH TOUR COPR <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT _RLOCK_Of <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 AUTHORIZED AGENT DATE <br />Oft ADDRESS <br />Llca muhlll�6 luc+ <br />�O <br />x <br />PLUMBING <br />MECHAN AL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPEfFF EQUIPMENT <br />FEE <br />SY All R CLOSE 117011E 71 <br />Al.EIS—TIP EA <br />RFIRIGERAIION UNITS —HP IA <br />ISAIH7UD <br />LAVATORY P%AA1 RMINI <br />ROILY RS—H P L A <br />GAS FIRED AC UNITS —TONNAGE EA <br />SHOWER <br />FORCED AIR MSIEMS—II 1 U MIA <br />KITCHEN SINK A 1) %P <br />\VALE HEATERS—IITU M <br />DIS\VASMEN <br />UNIT KUMERS—BTI M <br />I AUNDRY IRA) <br />1 VAPORATIVF COOLERS <br />( 1 O1HI S \VASHI R <br />S\'ATIR HEATER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />I'RINAI <br />DRINKING IOU11AIN <br />RANGE HOOD <br />AIR HANDLING UNIT— C F AT <br />I IOOR DRAIN <br />VACUUM HRIAKIRS <br />SIOI'E <br />ROOF GRAINS—RAINLI AUI RS <br />KIITAE IIRII'LACE A CHIMNEY <br />SINK ISFRVICl—BAR 17('1 <br />SUB 70TAL <br />SUR 70TAL B <br />O <br />OJ <br />PERMIT <br />1 <br />PERMIT IF <br />IOTA( III <br />S <br />TOTAL FEE S <br />O <br />SIDE YARD SL 111ACK <br />STREET SETBACK <br />RL.AR YARDSITBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FIE <br />RECEIPT NO <br />USE ZONE <br />!Or AREA <br />VACANT SITE <br />fits <br />VALUA710M <br />FEE <br />❑YES ONO <br />TYPE Of CONS <br />OCCUPANCY CROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE Of BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIR[ ZONE <br />IIASEAI[NT <br />❑1 OROUMS <br />RIQUIRf <br />OKLERS <br />MECHANICAL <br />(lYFS ❑NO <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U <br />SEC 30144 <br />TOTAL <br />2 BUILDING PLANS <br />1 FIRE IIIDRANI <br />A FIRE PROTECTION SYSTIM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />5 GRADINGa XCAVATIONSCIIARING'GRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />A HFALTHDISTRICI <br />APPIICAl10N ACC flY <br />PlAN1 CHECKED BY <br />APPR FOR ISSUANCE BY <br />NO <br />J <br />L <br />9.1.79 <br />