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. � (� <br /> APPIICATION FOR ' �. everen <br /> fMEv�rprwn C�.. NSTRUCTION e <br /> • dtY OF <br /> everett PERMIT <br /> DEPT. OF COMMUNITY �EVELOPMENT SERVICES <br /> CITY NALL 259�8715 <br /> EVERFTT,WA9B201 ��OMSINATION ❑ SUILDING ❑MECMANICAL ❑PLUMlIWG PERMIT NO. <br /> ON' fR MMI �D�k155 CII ZIP PNONE <br /> �11�rv �� r�2v �Y $�a4 �S-�2� �� /�t �l,fRysu���E ��,� .� 6s� - y�s�l <br /> �II[NI11CtORD[SIGMER MAII��UII[SS UTY 21P YHON[ <br /> QNFNAICONIR�CLOF n1All�DDRE55 CI1Y 21P PNON[ UCENSEI <br /> n�tCH�NIUt CONIq�Ct00. MAIt�OORE55 CIIY LIP (MJNE IICFNS[1 <br /> Pll�s�pWG(OMINACIOR MMlA0DRF55 CIIY LIP PNONF IICENiF� <br /> CLASSOf WOR[ � <br /> ❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> �wwnunn or woaa <br /> f � �O - <br /> OIS[RIPF H'00.t ( I <br /> �e roc �' fEw�'M �lc w5 E-' <br /> PROPOSlDUSf Of PUIIUING I IiEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> pLICATION AND KNOW THE SAME TO CE TRUE AND CORRECT ALL <br /> IFGAlO[SCRIYIIOYOf PNOPERtY�SNOWN B[lOW OP�l"�CN IOURCOFIf51 PROVISIONS OF UWS AND ORDINANCES GOVERNINC THIS TYPE <br /> T OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ioi _r;«k__oF tVCrr � � �� � OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> r GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> "b -p� -�. SOFI o� N I�7S� n� C I ° ��k � OR THE PER ORM NCE OFAC `NSTRUCTION ING CONSTRUCTION <br /> /0/O G SICN�TURE OF CONTRACTOR O A iHORRED AGFN1 DATE <br /> c�, � <br /> �oA,���55 x f�lah,v�.w; /3 S� <br /> ve r - t1 <br /> ►W M�ING MECMANICAL <br /> � NO. TV►E Of FI%TURE FEE NO. TYI�OF EQUI►MFNT FEE <br /> W�TFRCLOSETIfOUfTI AIRCOND UNITS—HP.EA <br /> BATMTUB REfRICERATION UNITS—H P.FA <br /> UVATONY IW�SM BASIN) BOIlERS—M P tA <br /> $HOWFR GAS FBfD A2.UNITS—TONNAGE E� <br /> KITCHEN 51 JK 6 OISP FORCED AIR SYSiEMS—B.T U. M F� <br /> DISWASMfR H'�«HEATFRS—BTU M <br /> LAUNORY TRAY UNR HF�TERS—B TL. M <br /> Cl01ME5 W�SNER EVAPORATIYf COOLERS <br /> , WATER HEATfR CIOTNFS DRYERS - <br /> � UR�NAL VENIIUTION FAN <br /> DRINKING fOUNTAIN NANGF HOOD <br /> FLOOR OPAIN AIR M�N�LING UNIT— C.F M. <br /> VACUUM BRFAKERS STOVE ' <br /> ROOi ORAtNS—N�INIE�DFRS MEUI FIREPLACE 6 CHIMNEI', <br /> SWK(SERVICF—BAR,ETC 1 <br /> SU�tOiAl SU�iOTAI f <br /> rFRMIi f ►EIIMIT � <br /> TOiAI iEF � TOTAI F[E s <br /> SIDE Y�RD SFTHACK $TRFFT SCTBACK REAR YARD SFTBACK PIAN CH[CK NUMB6R ^lAN CNFCK FEf <br /> fEE RECFIPTNO. <br /> USE ZONE lOT AREA yAC�NT SITF IEES VALU�iION iEE <br /> OYES ONO <br /> iYPE OF CONST OCCUPANCY GROUP NO Of DWFIIINL UNITS � <br /> BUiI�'NC f � <br /> SIZF OF BLDG NO OF STORIFS MAX OCC IOAD <br /> PIUMBING <br /> FIRF ZONE BASEMFNt HIOROOMS REQUIRfI�NKI[RS MFCHANICAL <br /> ❑YES ❑NO <br /> AM�OVAU �T DAiF OTHFR <br /> i. ENVIRONMENTAL CMECK II;T pEN,1LTY UB C. <br /> SEC 1071e� ^� <br /> i. BUIIDING PUNS <br /> iOTAI <br /> J FIRE MYDRANi <br /> � IIRE PROIFCTION SYSTEM R�MIT VAlID�710N <br /> WHEN PROPERLY VALIDATED IIN THIS SP�CEI THIS IS YOUR PERMIT <br /> S GRAOINGIE%CAV�TION6ClEAR:NGICRUBflINL <br /> 6. D0.AINAGF <br /> 7. ENVIRONMCNTAL IMPACT STATEMENT , <br /> E. MEAIiH DISTRICT <br /> APPIIUTION ACC BY P�ANS CMfIXED BY APPR FOR ISSUANCE BV <br /> 9�1�79 <br />