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FFN EYPFo?W <br />CITY OF <br />ALICATION FOR <br />NSTRUCTION <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 35"745 <br />EVERETT. WA9Ei01 ❑COMBINATION <br />MAIL <br />❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />v <br />ZIP PHONE LICENSE F <br />PIUMBING CONTRACTOR MAIL A00RISS CITY ZIP PHONE LICENSEE <br />CLASS Of WORK � <br />❑NEW []ADDITION❑ALTERATION ❑REPAIR ❑DEMOLITION 9 NCE ❑SIGN ❑GA0.AGE ❑BUILDING RELOCATION <br />VAIUAIION Of WORK ^ <br />S �V <br />DESCRIBE WORK <br />LL4 1LY Vll Y(1L� Sia�cl <br />PROI'ORO USE OF-c �ILDILC --- <br />LEGAL DESCRIPTION OF PROPERTY ISHONN BELOW OR MTAC�1 yR COPIES) <br />-�� c� <br />TC/'tnn <br />LoIRIOCK,12y_ 01 <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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />-1 : 1 <br />IOBA ORISS _ 1 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOLI17) <br />AIR COND UNITS -HP EA <br />BATHTUB <br />RI FRICERATION UNITS -HP EA <br />LAVATORY (WASH BASIN) <br />BOILERS-H P EA <br />SHOWER <br />GASFIRED AC UNITS -TONNAGE FA <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS-B T U M EA <br />DISWASHIR <br />WALL MEATERS-BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS -BTU M <br />CLOTHE 5 NNSHI R <br />I VAPORATIVE COOLERS <br />WATER HEATER <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 />STOVE <br />ROOF DRAINS-RAINL 1 AM ITS <br />METAL FIREPLACE A CHIMNEY <br />SINK (51 RVICL - BAR. LTC 1 <br />SUB TOTAL <br />SUS TOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL IEE <br />S <br />TOTAL <br />FEE S <br />SIDE YARD SI TRACK <br />STREET SETBACK <br />RUN YARD SETBACK <br />PUN CHECK NUMBER <br />PLAN <br />FEE <br />Cl/ECK FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />51ZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />BEDROOMS <br />FIRE <br />SPRINKLERSREQUI <br />FISTS ❑NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK • 1%7 <br />PENALTY <br />UBC <br />SEC JDNA) <br />2 BUILDING PLANS <br />TOTAL <br />J <br />(� <br />7 FIRE HYDRANT <br />A IIRC PRC RC110N SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />S GRADINI,IIKCAVAFIONACLIARINGICRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMFACT STATENMENT <br />B HEALTH DISTRIC <br />Apr ALIGN A(BY <br />PLANS CHECKED BY <br />APPEL FOR ISSUANCE BY <br />9-1 79 <br />