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APPLICATION FOR <br />!Y <br />.° <br />�T CITY OF CONSTRUCTION <br />everett <br />PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT <br />EVLRETT, WA98201 ❑COMBINATION <br />PHONE <br />MAIL Al109ISS <br />OWNER <br />F/PQ( r' , IglA / C'N✓fc'iI <br />CITY ZIP <br />Z93C- /fociccFELJ"qz cl / .Z.S 7 ` <br />P HONE <br />1<S'r CITY TY ZIP <br />ARCHITICI OR DISIGNIR MAIL ADD0.f SS <br />(��f PU.6orS}E6 LY"NN�✓o�� %fIU36 775-795'9 <br />S�vc���Tc rnJ�%SS'o�. <br />CILY ZIP r'0'1 1z j L¢/NstE <br />61HIRM CONTRACIOR MAIL ADDRESS <br />// �o,�n/I �D, <br />l3roX %SO Zrv<w.Err13y-9/9� ^�.r,A_ E-c Ito <br />�,ELL/LIRACTU (, JNJ <br />CITY LIP PHONE LICENSE <br />MICNANIUlC0N1RACLpR MAIL ADD0.[55 <br />CITY ZIP PHONE LICENSE IF <br />PLUAIEINC CONTRACIOR MAIL ADDRESS <br />[]SIGN❑GARAGE BUILDING RELOCATION <br />CLASS OI NORK,,��--,�(( []DEMOLITION ❑REPAIR DEMOLITION []FENCE <br />❑NEW 1 ADDITION ❑ <br />c 4UAt10N Of N'ORK <br />�/� <br />y UC1V• JU <br />DESCRIER WORK <br />THAT I HAVE READ AND EXAMINED THIS AP- <br />PROPOSE DUSE Of PULLDING <br />I HEREBY CERTIFY <br />BE TRUE AND CORECT ALL <br />PLICATION <br />T <br />Cy1 'lc L/ <br />PROVES ONS OF LAWS AND ORDINAONCES GOVERNING H 5 TYPE <br />LEGAL DESCRIPTION OF PROPIRIY ISIIOWN BELOWORATTACH TOURCOPIES' OF WORK WILL B4 COMPLIED WITH WHETHER SPECIFIED HEREIN <br />GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT elocK—OL <br />C;R NOT THE <br />TO VIOLATE OR CANCEL THE PROVISIONS OF <br />GIVE AUTHORITY <br />OR LOCAL LAW REGULATING CONSTRUCTION <br />ANY OTHER STATE <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />3 <br />LOP nDDR155_ <br />2736 II C�A"EFt cG t,. <br />%� . <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF EQUIPMENT <br />FEE <br />NO. TYPE OF FIXTURE <br />FEE <br />AIR Coco uN1Ts-Hr to <br />W'ATLR CLOSE I ITOIIE II <br />REFRIGERATION UNITS —HP EA <br />BATHTUB <br />BOILERS —HP LA <br />LAVATORY (WASH BASIN' <br />CAS FIRED AC UNITS —TONNAGE [A <br />SHOWER <br />FORCED AIR SYSTEMS—B T U M EA <br />KITCHEN SINK A DISP <br />WALL HEATERS—B i U M <br />DISWASH[R <br />UNIT HEATERS —BTU M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOHIES WASHER <br />CLOTHES ORVFRS <br />WATER HEATER <br />VENTILATION FAN <br />-- <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT— C F M <br />FLOOR DRAIN <br />STO\'f <br />VACUUM BREAKERS <br />MF 7Al FIRFPUCE b CHIMNEY <br />ROOF DRAINS — RAINLI AD[ITS <br />SINK (SERVICE —OAR. I TC 1 <br />SUBTOTAL <br />IF <br />SUB TOTAL <br />PERMIT <br />IF <br />PERMIT <br />f TOTAL FEE <br />f <br />TOTAL FEE <br />YARD SETBACK STREET SETBACK <br />S z PLAN CHECK <br />REAR YARD SETBACK PLAN CHECK NUMBER HE <br />FEE <br />RECEIPT NO <br />SIDF <br />iV a/ 66'' <br />• <br />USE ZONE LOT AREA <br />VACANT SITE <br />FEES VALUATION <br />FEE <br />OYES ONO <br />TYPE Of CONST OCCLPANCY GROUP <br />NO OF DWELLING UNITS <br />S <br />6/-2 <br />BUILDING <br />SIZE OF BLDG NO OF 570RIL5 <br />MAX OCC. LOAD <br />PLUMBING <br />FIR[ ZONE BASPMENT <br />BI DROOMS <br />FIRESPRREQUIRED INKlERS <br />MECHANICAL <br />FTYFS LINO <br />By DAEF <br />OTHER <br />APPROVALS <br />JBC <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY IEC TORSI <br />2 BUILDING PLANS <br />TOTAL <br />S FIRE HYDRANT <br />PERMIT VALIDATION <br />VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />S FIRE PROTECTION SYSTEM <br />WHEN PROPERLY <br />S GRADINGIIXCAVATION&CLEARINGICRUBBINr <br />6 D6AINAG[ <br />- <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />R HEALIH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED By <br />APPR FOR ISSUANCE BY <br />91 79 <br />