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1 <br />` Ms Evergreen A P P L I C AT 1 O N F O R ���,�„ <br /> ����F CONSTRUCTION e <br /> everett PE RM IT <br /> DfPT OFCOMn7UNI1Y OEVCLOPMENTSERVICES <br /> CITY HALL 259�8745 <br /> EVERFTT,WA9B201 �COMBINATION O�BUILDING ❑MECHANICAL ❑PLUMBING PERMITNO. <br /> ow�ea +uu nouurss ate zir rrwrve <br /> � ;P6B/N� .�iQr�a��L /0/9�»63PGcc ��f��7T 9d1�/ ��z.6.�8L <br /> nN01111('IOXO[SIGNlR n1ALL pDXlSS Cliv 21P 1'110NE <br /> Gf NIqAt WNIqAC10R �Uil A�OR65 CIIY 21P PHON[ IICENSE� <br /> M1If[IIAVIUICONIQ�Cl00. �UIIADORF55 ���1Y LIP PNON[ IICFN5E1 <br /> PW��NP.f.(ONIXeC10P nullA0pNt55 UIY ZIP PHOIvF lIC[N5t1 <br /> 1.� <br /> � <br />� ClA$S Of 1\'ORN ,�,/ <br /> ❑NE\\' ❑ADDITION ❑ALTERATION 149REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARACE ❑AUILDING RELOCATION <br /> \'AIWIIOy,(ll\\'OBA <br /> �l5��f �� <br />, 0!S(NI(11\\U0.A <br /> GN-Cr� �U� <br /> raoros�ous� or xunmvc I HERE[lY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO f3E TRUE AND CORRECT ALL <br /> ucu oiscaivuov or raovinrr ivwwn xnaw on�ir.o�roue mrusi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK 1NILL BE COMPLIED WITH \NHETHER SPECIFIED HEREIN <br /> ioi _uiocr:_or OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO V�OLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> S ATURE OF CONiNACTOR OR AUTHORIZED ALENT DATE <br />' j�/ ���7����� �G C�� c�--�S� <br /> � <br /> PIUMBING MECHANIGL <br /> NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE <br /> �vnna aostT irouen �iH coNo ur+rts—��r u I <br /> HAIHIUP R[fRIGERAT10YUNITS—HP EA <br /> IAtlATORY I\YASH OASINI HOILlFS—H P U . <br /> SNo1YfR GAS�IR(D�� UNIiS-10NNAGEU ' <br /> KRCMIN SINK 8 DISP fORC[U AB STSTLMS-0 T U M EA <br /> UIS\\'ASHfR \\'All HkA7fRS—!I7 U M <br /> IAUM1�H\' 7RAP UNI7HU7(NS—OTV M <br /> CLOiH[S�vASN[R f\'APOHAiIV[COOLERS <br /> \vAl E 0.IIUIE H CL01H[S DRl E RS <br /> UNIN�I VLNLU7104!AN 1 <br /> f)RINKINC fOUN7AIN RANGf HOOD I <br /> f IOpR UHAIh AIR IIANUUNL UNIT— C f h1 <br /> VACUUAI I)R{AAl R$ $l OVI. <br /> NOOf DHAItiS—RAINIUDLNS M[TAl IIRFPUClBCHIb1N[V <br /> SIN�6ER\9C[—f1AR f 7C l <br /> SUlTOTAL SUliOTAI s <br /> tERMIT S P[UMIT S <br /> TO7AlfE[ S iOTAIFFE s <br /> SIUf YAHD 5[i.tnCK STR[[T 5[TMC1: ftUN 1"ARD SI7IIACK PLAN CIICCR I:U,VIIIR PLAN CHECK FFE <br /> F[E RECEIPT NO <br /> US[ ZONL LO7 ARLA ���UNT SIIf <br /> ❑Yf5 ❑ND FEES VALUATION iFE <br /> iYPC Of CON51 OCNPANCI GROUP NO OF DWLIIING UNIi$ <br /> UUILDINL S <br /> A2[ OF BLDG NO OF S70RIE5 MA% OCC IOAO <br /> PLUMOING <br /> fBLZONC I1Al[MFNI Ii1DNUU.VS IIRESFNP�AlIRS <br /> RIQUIKkD MECIIANIUL <br /> fiY15 f1N0 f <br /> '' APfROVAIf !Y DATE OTIifR �1 <br /> 1 fNVIROtiMlN7ALCM[CKLIST P�N^�T� U.tlC <br /> SEC ]O)(a) � <br /> a ouauinc rinr,s <br /> TOTAL <br /> ] FIXI HYDXANT <br /> � FIRF PROTECTION SYS7EM ►EIIMIT VALIDATION <br /> WIIEN PROPFRLY VALIDATE�IIN TMI$$PACEITNI$IS VOUR PFRMIT <br /> 5 GNADII:CIIACM'AT�ONbQUNINGIGflU8171NG <br /> 6 DRAINACE � <br /> 7. FNVIRONMFN7AL In1PACT$lAT[MfNT <br /> B MFALTII DISTRICT <br /> APPLICATION ACC.BY PLANS CHFCKED BY �PPN FOR ISSUANCE DY <br /> 9 1 79 <br /> �� <br /> . � <br />