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everetl <br />everett CONP RMITTION e <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, VIA98201 ❑COMBINATION �9 BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNER Ault AODRISS CI III' PHONE <br />✓ ct-a-c-. �J�,� apti�/l �l'!�r zl��� //�k' �iA-cc�.Z% l��'•� r]�� -,'.S3 - 7S� �/ <br />ARCHITICI OR DISIGNIR MAIL AUDRISS CITY ZIP PHONE <br />Gft.LR�t CONTRACTOR �, <br />c�ts�16 <br />MAIL ADDRESS <br />L< l <br />CITY <br />e ,`e_ 4 C cCl <br />ZIP <br />� �lar <br />PHONE LICENSE <br />js3 JS"� v <br />MECI ANICAL CONTRACTOR <br />MAIL ADDRISf <br />CITY <br />ZIP <br />PHONE LICENSE IT <br />PLUMBING CONTRACTOR ANTI ADDRISS CITY ZIP PHONE LICENSE <br />CIA 5OF WORK <br />NEW ❑ADDITION ❑ALTERATION <br />VALUATION OF WORK tyo-5 <br />E Asz;�W. <br />DESCRBIL WORK <br />PAIR ❑DEMOLITION ❑FENCE ❑SIGN OGARAGE ❑BUILDING RELOCATION <br />PROPOSED USE OF BUILDING U V I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAM! TO BE TRUE AND CORRECT ALL <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LOT BLOCK CC of ec Lr+� OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />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 LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AU IHORIZED AGENT DATE <br />LOB ADDRESS 2ii.SA. L . iP iA-/ _ X {�/ d�,L S// /.IP% <br />PLUMNING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOLIFTI <br />AIR COND UNITS-H P [A <br />BATHTUB <br />RE IRIGERATION UNITS-H P. LA <br />LAVATORY (WASH BASIN) <br />BOILFRS-H P EA <br />SHOWER <br />CAS FIRED AC UNI-`-TONNAGE EA <br />KITCHEN SINK 8 DISP <br />FORCE D AIR SYSTI' -GT,U. M EA <br />DISWASHER <br />WALLHLATERS-BTU AT <br />LAUNDRY TRAY <br />UNIT HFATERS-BTU M <br />CLOTHES WASHER <br />I. VAPORAT IVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS _ <br />URINAL <br />VI NTILA110N FAN <br />DRINKING FOUNTAIN <br />R.ANCL HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- CENT <br />VACUUM BREAKERS <br />SloVI <br />ROOF DRAINS -RAINLE AW RS <br />AU TAT FIRI'^: SCE A CHIMNEY <br />SINK (SERVICE -BAR, ETC) <br />SUB TOTAL <br />SUB TOTAL <br />S <br />PERMIT <br />$ <br />PERMIT <br />S <br />TOTAL FEE <br />S <br />TOTALFEE <br />S <br />SIDE YARD ^ SETBACK <br />424= <br />STREET Si TRACK <br />20'--�-3�.�/� <br />REAR YARD SE IBACK <br />PLAN CHECK NUMBER <br />/ (.. 60 <br />PLAN <br />FEE <br />, <br />CHECK FEE <br />RE/4I EILPT•�- NO. <br />� <br />T V �+S <br />USE ZO E <br />✓ <br />LOT AREA <br />VACANT iE <br />❑ CA T %11 <br />FEES <br />VALUATION <br />FEE <br />sa- <br />In <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF 5LDG E <br />30 k 3G0 <br />NO. OF STORIES <br />E <br />MAX JCC LOAD <br />PLUMB NG <br />FIRE ZONE <br />3 <br />BASE=PNF <br />19 DROOMS <br />IIRF SPRINKL FRS <br />REQUIR D <br />❑YL$ O <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTIEIR <br />1. ENVIRONMENTAL C11[CK LIST <br />PENALTY <br />U.BC. <br />SEC 307(a) <br />2. BUILDING PLANS <br />TOTAL <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />�D (�S(�j �Q (fSw-* a ,n <br />j1I <br />5 GRADINGII XCAVAI ION A CLL MONGICRUBFUNG <br />6 DRAINAGEe <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />R HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />VZ <br />APPR TOR ISSUANCE BY <br />a 1.?9 <br />b <br />