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- \ <br /> , <br /> fMEwryn�n APPLICATION FOR �- . ���,�„ <br /> ��TM�F IJNSTRUCTION � <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOP�NENT SERVICES . <br /> CITY HALL 259�8745 <br /> EVERETT,WA98301 ��OMBINATION ❑ sUILDING ❑MECHANICAL ❑PLUMlING PERMIT NO. <br /> OWNFR /� � M�II AOONt55�,/ CIIY ZIP// PHOHE �i <br /> �� ��d,.r�Yi-,� 1�/ �� ai � ,c"�,e1t� ,�'�"„20 � 23 7— — �D.��o <br /> ARCNR[CT OR OE CHEN 'nf�IL AODRESS CITY 211 YNONE <br /> GfNEMICONtR�[IOR MAIL�OORE55 UTY ZIP PNONE lIC[NSEI <br /> n�ICN YIUI CON eC10P / M�II�pORF55 CI1Y LIP FIONE UCENSE� <br /> � �`iLh� <br /> PIU��fliNLCOrvIpA[lON M�IL.IODR[55 CIIY 21P PMONE UC[NSE� <br /> Cln55OI WOFK <br /> �INEW ❑A�DIiION ❑ALTERATION ❑PEPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDINC REIOCATION <br /> \AW�IIOMOf WORK <br /> s •1 n/. � <br /> oiscainc woa� - <br /> roo�oan us[or nm�oi�c I NEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �(GAlpISCRIP110NOf P0.UVEFIYISNOWN81lOW ORAIUCHiOURCOPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> io� _eior.K_ov OR NO7. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW RECULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SILNATURE OF CONTRACTOR OR AUTHORIZED AGENT OAiE <br /> iox.00wns �/ ' ��_ li .l <br /> �. 7( � /�- o �� <br /> PIUMBING MECHANIGL <br /> NO. TY►E OF FIXiURE FEE NO. TY►E Of FQUI�MFNT FFE <br /> WATFRCLOSfT�TOIIFT) AIRCOND UNITS—MP EA <br /> PATHiU� RFFRILERATION UNITS—H P.E� <br /> IAVATORY�WASH BASIN� flO1LER5—H P EA <br /> SMOwER CASFlREOA.C.UNRS—TONNAGEEA <br /> KI7CNFN SINK 8 DISP F00.CED AIR SVSTEMS—B T U. M FA <br /> DISN'ASMEB \YAIt MEATFR$—B1.U. M <br /> UUNORY TRAY UNIT MUTERS—B T U M <br /> ClO7ME5\VASNER EVAPOR�iIVE COOlE85 <br /> '� WATER MUTFR CIOTMES ONYERS <br /> URINAL VENTILATION FAN <br /> '�5 ORINKINC FOUNTAIN RANGF MOOD <br /> f1000.DRAIN AIR HANOIINC UNIT— C.F M <br /> VACUUM 9NFAK[RS S10VE �- � <br /> ROOF ORAINS—RAINIEADEdS n1ETAl FlREPUCE 8 CNIMNEV <br /> SINK�5[N V�CE—BAR.F I C I <br /> SUBtCiAI SUS TOiAI � <br /> ►I.TMIT ! ►f�MIT f <br /> TOiAI iFE 7 TOTAI FFE s <br /> � SI�F VARD SCTOACK STR[ET SCTlIACK RUR YARD 5[70ACK PUN CII[CA NUnIBER PLAN CHECK FEE <br /> FFE 0.fCEIPT NO. <br /> USF ZONE lOT AREA yACANT SITE {EFS �AIU�TION IFF <br /> ❑YES ❑NO <br /> IYPE OF CONST OCCUPANCY GROUP NU OF DWELLING UNITS <br /> � BUILOING f <br /> SIZC OF tlLDG NO OF STORIES MA% OCC IOAD <br /> PWMOINC <br /> I <br /> FlN[ ZONE BAS[M[YT IIIUHOOMS REQUIHEDKlERS M1���HANIUI ,S� <br /> ClYFS CNO <br /> A►►ROVAlS �� DATF OTHER <br /> 1 LNVIRONAQNTAICHECKLlSi PFNALTV ���� <br /> SEC.JOIIaI <br /> 1 OWIDING PLANS � <br /> TOTAI <br /> d FIR[ HIDHANT <br /> � fl0.E P0.0TfCTION SYSTEM �EIIMIi�AllOAiION <br /> WHEN PR07ERlY VALIDATFD IIN TI/IS SPACE)iN1515 YOUR PFRMIT <br /> 5 LHADIN.:�FAU\'ATIONbCIFANINGlGRUNBING <br /> 6 ORAINACF <br /> 7 ENVIRONMENTAI IMPACT STATkMENT <br /> e i�rnun oisraict <br /> APPIIGTION ACC BY PUM1S CMECKED BY APP0. fOR ISSUANC[ H� <br /> �11 ''� <br />