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APP1-ICATION FOR evereIt <br />CCASTRUCTION e <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPAILNI SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA98201 []COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />—cvcy a `/Gu5 36y/ /Zoce/tEr��c�2 FVA-nr� r-?x"24yI <br />dAS'6 <br />ARCHIHCI )R DESIGNER MAIL ADURISS CIt)III' -NON! <br />SB�F" <br />CENTRAL CONTRACTOR .%Ali ADDRESS CITI Ili, PHONE HCENSEIt <br />MICHANICAL CONTRACTOR MAIL ADDRESS ( 1I1 Ill. PHONE LICENSE E <br />MAIL ADDRESS ❑n IF, PHONE LICENSE <br />CLASS OF WORK IX <br />GARAGE IRADDITION ❑ALTERATION ❑REPAIR ❑DLMOLITION ❑FENCE. ❑SIGN IXGARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />E <br />DESCRIBE 1YORK %k / 7 $� 20O <br />PROPOSED CS1 OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />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 />SIGNATUR F CONTRACTOR OR AUTHORIZED <br />///..AGENT DATE <br />LEGAL DESCRIPTION OF PROPERTY ISIOWN BELOW OR ATTACH [OUR COPHSI <br />LOT ar/ iF; <br />��BLOCK �3 S—a ��t @ A_% ✓ <br />HOB ADDRESS <br />PLUMBING <br />MECHANICA <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOLIET) <br />AIR COND UNITS —HP. [A <br />ED—HTUB <br />REFRIGERATION UNITS—H I'. LA <br />LAVATORY (YYASH CASIN) <br />BOILLRS-H P. LA <br />SHOWER <br />„L <br />GAS FIRED A C UNITS -TONNAGE EA <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS-B.T.U. MIA <br />DISWASHER <br />WALL HEATERS-B I U At <br />LAUNDRY TRAY <br />UNIT HEATERS-11 T U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATI.R <br />'IB' <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKERS <br />STO\'1 <br />ROOF DRAINS-RAINLFADERS <br />METAL FIRIPIACF A CHIMNFI' <br />SINK (SERVICE -BAR. LiC ) <br />SUB TOTAL <br />SUB TOTAL S <br />PERMIT <br />S <br />PERMIT ! <br />TOTAL FEE <br />S <br />TOTAL FEE B <br />SIDE YARD SETBACK <br />3/RZ F O1 <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />OS� <br />PLAN <br />Flf((�A <br />I�G-F <br />CHECK FEE <br />RECEIPTNO <br />USE ZONE <br />LOT AREA <br />VACANT Slit <br />DYES KIND <br />VALUATION <br />FEE <br />IYPt OF CONST�. 1 <br />N <br />OCCUPANCY GR <br />ZZ' <br />NO. OF DWELLING UNITS <br />' <br />OUR DING <br />3 <br />'4y <br />T <br />OF)SIZE <br />OF BL /C Fi <br />7 K 1-7 <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />y <br />FIRE ZONE <br />BASIMLNT <br />III GROOMS <br />FIR[: SPRINKLERS <br />REQUIRED <br />WS ❑NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I. ENVIRONMENTAL CHECK LIST <br />I'I NAl 11. <br />1111 C <br />SIC 307(a) <br />2. BUILDING PLANS <br />T TIRE HYDRANT <br />TOTAL <br />/� <br />O <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />W'HI N PROPERLY VALIDATED (IN THIS SPALFI THIS IS YOUR PERMIT <br />ry C' �Y <br />Sl pifr.„ „/ <br />5 GRADWGII KCAVATION A CUARINGIGRUEIBING <br />G DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATIMENI <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHUCKED BY <br />Y A <br />AI'PR. 1 OR ISSUANCE III' <br />