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l <br />i <br />FA. EwrpnPn APB LICATION FOR <br />CITY OF CONSTRUCTION ` <br />everett <br />UEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA9e1B1 OCOMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNER MMl 1Ul1-15 <br />cH1 11r PHONE <br />OR <br />MA <br />CITY ZIP <br />PHONE LICE <br />%4CHANICAI CONTRACTOR ANAII ADDgI SS <br />CITY LIP P110Nf <br />LICENSE R <br />Pit 'Ki"'%t;CONTRACTOR MAIL ADDRESS <br />(I1Y lip PROM <br />llC[N5F F <br />LI 411 Of WORK <br />❑NEW ❑ADDITION ❑ALTERATION IBREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />\ ALL ATIM OF WORK <br />f <br />❑I AC RILL W9RL <br />Y <br />rxOrt Il ptI 6f <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT,&L <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 />SIGNAIURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />H I. At DI AT RI PT 101 OF PROM R I I Isll0Wx�UOW OR ATTACH JDgu °NtA /+ <br />LIST <br />y'7 <br />0 <br />I08 AODRI St <br />PLUMING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />WATE R CLOSE I I TOLIFII <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />AIR CONIC UNITS —HP LA <br />FEE <br />BATHTUB <br />RIGf RATION UNITS—Hf LA <br />1 AVA TORV IWASM flA51N1 <br />HOLUIL[RS—N P LA <br />SIIOW'F R <br />GAS I WE D A C UNITS —TONNAGE [A <br />KITCHIN SINK A DISP <br />FORCED AIR SYSTEMS—B T U M EA <br />DISWASHIR <br />WALE HEATIRS—BTU Al <br />LALINDRN IRAI <br />UNIT HIMIRS—IIIU M <br />CLOIHIS WASHIA <br />1\'APORA 71\'f COOLERS <br />NATfR HEAT <br />CIOTHIS DRVIRS <br />URINAL <br />\'INTILAIIG.N FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT-- CFM <br />FIOOR DRAIN <br />VACUUM BRI AKI RS <br />SI(l\'I <br />ROOF DRAINS— RAINU AUE RS <br />ME TAT I IRf PLACE A CHIANNEY <br />SINK ISFRVICF —BAR. T lC 1 <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />PERMIT f <br />TOTAL FEE S <br />TOTAL FEE f <br />SIDE IARD SI TRACK <br />STREET SETBACK <br />REAR YARD 511BACK <br />PLAN CHICK NUMBER <br />PI AN <br />!!T <br />CHECK FEE <br />RECEIPT NO <br />USE ]ONE <br />LOT AREA <br />VACANT 511E <br />DYES DNO <br />FEES <br />VALUATION <br />FEE <br />7VPE Of CONST <br />SELF OF BIOG <br />OCCUPANCY GROUP <br />h0 OF STORIES <br />NO OF DWELLING UNITS <br />MAX OCC TOAD <br />BUILDING <br />S <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />III GROOM% <br />FIRE SPRINKLIRS <br />REQUIRED <br />DYES [,NO <br />Mf CHANICAL <br />A"ROVALS <br />BY <br />DATE <br />OTHER <br />I ENVIRONMENTAL CHICK LIST <br />PINAIIN <br />UBC <br />SIC 1011A1 <br />7 BUILDING PLANS <br />T FIRE HYDRANT <br />OTAL <br />A FIRE PROlf C71ON SYSTEMPERM <br />VALIDATION <br />PROPERLY VALIDAI[D (IN THIS SPACEI THIS IS YOUR PERMIT <br />S GRADING4 AT AVMIONA CIE ARINGIGRUHBINGHEN <br />6 DRAINAGE <br />EtSSUANLI <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />A HFAITH OISTRICT <br />APPLICATION ACC BY PLANS CHECKED BY <br />FOR <br />