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� <br /> i <br /> ��.E�,,�.� A�?PLICATION FOR.- <br /> c'ryoF ��NPERMITTION °"e <br /> everett <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259�8705 � <br /> EVERETT,WA7B:ot ❑COMBINATfON ❑ BUILDING ❑MECHANICAL ❑PLUMCING PERMIT NQ. <br /> �w��R MAII�OOX[55� <br /> CITY IIP PMONE <br /> ' X Flnl3ir� SrRhND�LL I Olq yv�RPLL �i�P�rr— ���n J v'tSGZ638�— <br /> AqCNtt [IpqO[SIG IR M�IIAppR[SS <br /> [ITY ZIP PMONF <br /> GIN[R�lCON1PAROR MAII�DONF55 ��TY <br /> x �) � ZIV VHONE IICFNSE� <br /> C'�' ��� <br /> IfCHA IGl CO tR��iOR M�II�DORlA ��T� tiP � <br /> PHOHE tICE�.E I <br /> Pllr\IpINGCONiA�C10X M�Il�D�0.[A ��Ty <br /> ZIP PMONE IICENSF� <br /> CI nS5 Oi N'O0.K <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELUCATION <br /> �atwnoti or woaK <br /> s <br /> DISCFIP[WORK <br /> � L w <br /> � <br /> PROPOSlO USt OI flUIl01NG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PUGTION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> l[G�lOfSCpIP110Y0iPqOPFP7Y�5NOW�+qfIOWOR�II�CNIpUNCOPIf51 PROVISIONSOFLAWSANDORDINANCESCOVERNINGTHISTYPE <br /> io�_e�oc�_o� OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 70 <br /> GIVE AUTIIORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER $TATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SICN�TUR[ OF CONTRACTOR OR AUTMORIZED AGENT DATE <br /> IOP eDDRf SS <br /> • k o��i ✓�r�P�� v��2c—�-�- �8�� X - —F9 <br /> PLUMlING MECHANICAI ' <br /> NO. TY►E OF FIXTURE FFE NO. TY►E OF EQUI�MENT FEf <br /> WATER ClOSR(TOLIET� AIR COND UNITS—M P. EA <br /> BATHTUP <br /> RFFRICERATION UNITS—H P.EA <br /> IAVATORY�WASFI BASIN) BOILERS—N P EA <br /> SMOwFR <br /> CA$FIpED A.0 UNITS—TONN�CE EA <br /> KI7�HEN SINK 6 OISP fORCFD AIR SVSTFMS—B 7 U M EA <br /> DISWASM[R <br /> IAUNDRY TRAY W�LI MUTERS-8 T U M <br /> UNITHEATERS—B.TU. M <br /> _ CLOTHFS WASHER l:ePORATIVE COOlERS <br /> WATER MEATER CLO1Mk5 DRYFRS ' <br /> URINAI <br /> VFNTIL�TION FAN ' <br /> DRINKINC FOUNTAIN <br /> RANGEMO00 — <br /> iIOOR ORAIN <br /> VACUUM BRFAKfRS AIR HANDLINC UNIT— C.FM <br /> srovc Q <br /> POOf OR�INS—RAINLFADERS METAL FlREPLACf 8 CHIMNEY <br /> SINN�SFRVICF—BAR,FTCI <br /> SU�TOTAI SU�TOTAI f <br /> KRMIT { ►[IIMIT { U <br /> TOTAtIfE f TOtAIiFF � � <br /> SIDE YARD 5[TBACK SiRFFT SCTBACK RUR YA0.D SFTBACK PLAN CNCCK NUMBE0. PLAN CHEIX FEE <br /> FEF RECEIPT NO. <br /> USF ZONE LOT AREA yAC�NT SITE <br /> ❑YFS ❑NO IFFf VALUATION �([ <br /> TYPE OF CONST OCCUPAN[y LROUP NO.OF DWFILINC UNITS <br /> SR[ OF BIDG NO Oi STORIES MA% OCC LOAD BUILDING S <br /> PLUM�ING <br /> FIRE 20NF BASEMFNT NlDROOMS �INE SPRINKLENS <br /> XEQUBEO M[CHANIUL <br /> C7YF5 ❑NO 5� <br /> AMROVAIf �t DATF OTHER <br /> 1 ENV10.0NMFNTAL CMECK LIS7 <br /> PENALTY UBC. <br /> 2 9UILDING PlANS SEC. 30Nq <br /> J FIqE NYDNANT TOTAt <br /> � FINF PROIFCTION)YSiEM ►[IIMIT VAL�DAiION <br /> 5 �RAOING!%CAVATIONB CLURINGIGRUBflING WHEN PROPERLY VALIDATfD�IN TMIS SPAfEI THIS IS YOUR VERMIT <br /> 6 DRAINACF <br /> 7 fNVIpONMENTAIIMPACTSTAiEMENT <br /> E HFALTH DISTRICT <br /> APFUUTION ACC.BY PUNS CHECKFD BY AFPR.fOR ISSU�NCE BV <br /> 9�1�79 <br /> —� <br />