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�e+ , r . � I--�' 7� 1 <br /> APP�-�CATION FOR �� e�e�e„ <br /> �' CO� �STRUCTION e <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPMFNT SERVICES . � <br /> CITY HALL 259-8745 � <br /> EVERETT,WA98201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. ' � � ' <br /> O1YN[fl , AIAlLA1JIJNIS� Clll ].II' PlION[ � . <br /> �:�. ...�-L�A-�� l//H �_R�� ��r- _ <br /> �R[IIIItCI 00.pELLNtN MAII ADDR[55 [lil" ZIP PIIONL <br /> GIN(RAICOMqACIOR -�— AInIlA000.65 CIIY ZIP PMOUE lK[NS[M I <br /> ' Lz� 3e1s— � �'>-S � � ^ _ 3 <br /> M[CIIA AICO�IPAOOR M.1 �ORL55 CIIY CIP PNON[ IICFNSEM py <br /> PLUMPING CONTXACiOR MAII nDDN[55 UlY i-IP PIIONE ��«NSL 1 <br /> CU55OI W00.K <br /> ❑NEW ❑ADDITION ❑ALTERATION LgREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION : . � � <br /> VAW�TIONUlN'OXK '' , .- <br /> + 3 0�-� � <br /> otscai woae � � <br /> � . i <br /> / b' • q/' <br /> reoroscoust nmioi�:c ' I HERE6 CERTIFY T I HAVE READ AND AMINED THIS AP� � <br /> PLICATION AND KNOW THE S�ME TO BE TRUE AND CORRECT ALL ! <br /> itcni o[sceirtior+or vaortatr�S��oN'r+nuowos nnnu UR COPIE51 PROVISIONS OF LAW$AND QRDINANCES GOVERNING THIS TYPE , <br /> c � � - Of WORK WILI. BE COMPLIED WITH WHETHER SPECIf1ED HEREIN <br /> ia��nioca��G or .�L's OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO � <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF � <br /> ANY OTHER STATE OR LOC�L LAW REGULATING CONSTRUCTION ' <br /> OR THE PERFORMANCE OF CONSTRUCTION. �� <br /> SIGNATUR[OF CONiRACT00.� R Al �qRIZED AGENT DATE , � <br /> �OBADDRf55 �f� � <br /> / / X �z�i,-.a �"S-�U <br /> , �LUM�INC MECHANICAI � <br /> �� NO. TYPE OF FI%TURE FEE NO. TYPE OF EQUIPMENT FEE � � <br /> I WATE0.CLOSET�TOLIETI AIR COND.UNITS—HP.EA . � <br /> � BAiHTUB RffRIC[RATION UnITS—H.P.EA � . <br /> � LAVAiORV�WAS�' '�ASIN) Q OOILtNS—HP.FA ' ' . <br /> I - <br /> SHOWEN GA5 FlRED AS.UNITS—TONNAGE EA <br /> � KITCIiEN SMK 6 DISP. ^ Q Q fORIID AIR 51'STLMS-9]L. M EA <br /> � DISWASHER N'AlL HEA1tR5-11.T.U. M � <br /> ' IAUNDNYTRAY UNI7N(ATCRS—D.T.U. M � <br /> CLOTHES WASMER EVAI'ORATIVC COOLERS '. � <br /> ' WATER HEATER CLOTHLS ORV[RS <br /> � URINAL VENTIU710Y fAN <br /> 1 <br /> DNINKING FOUNTAIN RnNGF HOOD <br /> � iIOOR DRAIN AIR HANDLINC UNR— C.f M. <br /> VACUUM BREAKERS S70V! � <br /> � ROOF DRAINS—RAINLkADERS .�1CTAL IIRFPLACC 8 CHIAINEV <br /> � SINK6ERVICE—BAR TC) - <br /> on <br /> SUB iOTAL d sue toui s <br /> ►FRMIT f PERMIT f <br /> TOTAL FFF f DO TOTAI FEF f <br /> $IDE YARD SETN�C� STREET SFTOACK RIAR YARD$ETfiACK PUN CHLCK NUMOCR PLAN CHECK(EE <br /> � Fkf RKEIPT NO. <br /> h <br /> USE ZONE LOT AREA yqUNT SIT[ , <br /> ❑VES ❑NO FffS VALUATION FFE <br /> TYPF.OF f�;�rST. OCCUPANCY GROUP NO.Of DWfLLING UNRS <br /> tlUILUING S <br /> SIZE OF 9LDQ NO.OF STORI6 MA% OCC LOnD <br /> I'I.UMI7ING . <br /> FIRE ZONE 9ASEM[Ni OI DROOMS fIRL SPHINKLEBS 1 <br /> RfQUBCO �\II.CHANIGL <br /> ❑VIS ❑NU <br /> APPROVALS W DAiE 01HFH <br /> 1. 4NVIRONMENML CHECK LIST U.RC � <br /> PCNnLTV S(C. J031a1 <br /> 3. BUIiOING PUNS <br /> ]. FIRE HI'DRANi TOTAI <br /> t FlR[ PROTCC710N$YS1F:61 PERMIT VALIDA710N <br /> \VMfN l`ROPIRLY VAUDATLD IIN ... _:)THIS IS VCUft PERMIT <br /> S.GRADINGI(%lAA'ATION 8 Ul ARINf,IGNUIIBING <br /> 6 DRAINAGE <br /> L ENVIBONM(NTAI IMPACi 57ATLMLNT <br /> B. HFALTII OISTRIfT <br /> 4PPIP_Aili�'. '�� lfl PLA'.�.Jll�:.il' :il �PI'H II�HI',•i '..�I Ii� <br />