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-.� ; -F-"--� <br /> , <br /> tMEvwpn�n AP�LICATION FOR - �� <br /> C�,NSTRUCTION °y"`" I <br /> cix oF � <br /> e�-erett PERMIT <br /> DEPT. OF l'OMMUNITY DEVELOPfdENT SERVICES � <br /> CITY HALL 25SB715 I <br /> EVERET7,WA9B201 ��QMSINATION Q�lUILDING ❑MECHANICAL ❑PIUMSING PERMITNO. � <br /> OWNlII � M�Il.1DDM[SS CITY 21P IHONF � I <br /> �1 �/ 7`-ok 9/R /�//,�P/E �i/�,�� <br /> ��CI T[ iORD[SIGNtN M�IIADORlSS ❑iY ZIP �HOHE <br /> � <br /> G[Ht„R�M� CONiR�CT011 /' /� IMql��0/qIIESS [ITY Zlp �� 7y pHOHF IICENSF I <br /> C�lC���GYC> (�-KJK -drt�'Fk Y-..� .3 Z U i/��E�� �/.1�2!/ 7�Z%� �Z- L'2-!l'�/ 7��C/ <br /> MlCM1N1Ul CO��iR�CiOR MAII�DDLLFSS CIT� 111 PMONE IICENS[I <br /> Pll.�uBI4GCOMMti011 M�II�DDRF55 ❑tY ZIP pHONE IiCENfE/ <br /> CU55Of W011C <br /> ❑NEW ❑ADDITION ❑ALTERATION CC�REPAIR ❑D�NOIITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDINGREIOCATION <br /> V�W�IIONOf W011K � - <br /> s �y�— <br /> o�,� E � ��,;I�r �- K �2�•ti � <br /> P0.0>OSlOUSF Of PURDING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- � <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL � <br /> IEGM OESCRIPIIONOi�P�RO.(P�FIIri�S N 6[IOW OR�IiACM fOUM COPIFSi� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE . <br /> io�y�'� eiocn / e V or � E,� �� . � OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> . OR NOT. TH': GRANTI�.0 OF A PERMIT�DOES NOT PRESUME TO ' <br /> GIVE AUTHJRITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW RECULATING CON'TRUCTION <br /> OR Ty RFORMANCE OF CONSTRUCTION. <br /> SICNATUREO CONTR CT O AUTHORIZEDALENT D�TE � <br /> IOP�DD SS �/ <br /> /� � ` <br /> �E- L`�/E,�E// C - O l2 �J- <br /> fWM� NG C NICAI � <br /> NO. TY►E OF fIxTURE iEE NO. � TY►E OF EQUI►MENT fEE <br /> WATER CLOSET(TOLIfT� �IR COVO UNITS-HP. EA <br /> B�TNTUB � REFpICfRATtON UNITS-HP EA <br /> UVATORV(W�SN BASIN) BOILE0.5-H P EA - � <br /> $MOWFR CAS fIRFD�C UNITS-TOHNAGE EA <br /> KITCHFN SINK 6 DISP fORCFD AIR SYSTEMS-B?.0 M EA <br /> DISWASHER WALIME�TFRS-BTU. M <br /> LAUNORY iRAY UNIT MFATERS-B.i.0 M <br /> CIOTHES WASHER EVAPORATIVF COOLERS <br /> WATFR NEATFII CLOTHFS DRYFRS <br />�.� URINAL yFNTIUTION FAN <br /> � DRINKING fOUNTAIN RANCE HOOD <br /> iLOOR DR�IN AIR MANOIING UNIT- �,f M. <br /> VACUUM BRF�KfRS SiOVF <br /> ROOF ORAINS-RAINlE�0ER5 METAL FIREFL�CE 8 CMIMNFY <br /> SINK(SFRVICf-BAR,ETC 1 <br />� fU�TOTAI fU�iOlAl � <br />( R�MIT � R�MIi { <br /> I iOTAItEF f tOTAIfEE � <br /> I SIDE YARD$fiBACK STREFT SCTBACK R[�R YARD SRBnCK PUN�HECK NUMBER PLAN CMECK FEF <br /> FEF RECFIPT NO. <br /> I USE ZONE LOT AREA y�CANT SITE <br /> ❑YFS ❑NO �«f � VAIUAiION �[E <br /> tYPE Oi CONSi OCCUPANCY CRJUP NO.Of DWFILING UNITS <br /> BUIIDING S � <br /> I SIZE Of BIDG NO.OF STORIfS MA% OCC lOAO <br /> 1 PLUMBING <br />� FIRf 20NF BASEMENi fllDNOOMS FIRf SPRINKlFRS <br /> PEQUiRFD MFCN�NIUL <br /> ❑YFS ❑NO <br /> AM�OVAIS �t DAi[ OTHFR <br /> 1 ENVIRONMENTALCHECKLIST <br /> 2. BUILDING PL�NS PENALTY SFC 103�a) <br />�' J fIR[ MYDRANT TOiAt �p. d71 <br />� p .7U <br /> � FI0.E PROTECTION$YSTEN� r[�MIT VAIiD�iION <br />� 5 Qq�DINGf%CAVATION6 CLEARINCiLRUBflING WMfN FROPfRLY VAIIDATfD pN TH�S SPACE)TMIS IS 7QUR`ERMIT <br /> 6 DRAINA�F <br />� 7. ENVIqONMFNTAI IM�'��T STATEMFNT <br /> E. HEALTH DISTRICT <br />� APPtICAIION ACC BY PLANS CHFCKED flY APPR fOR ISSU�NCF BY <br />