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., <br /> '1 <br /> � PPLICATION FOR ���rc„ <br /> ��`�"�`�' :.ONSTRUCTION 0 <br /> everett P��MIT <br /> DEPi OF CO��MUNITV DEVELOPMENT SERVICES <br /> CITY HAIL 259d1�5 <br /> evEReii.wnea7oi ��QMBINATION ❑ SUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> y�ry�p MAll4UDNISS � �I1Y ZIP FHONE <br /> � /lrs /)��o�i �Y`as ,�i� � /�ua�F'�� �of�eF�'i` ��,�o/ o2s.� 1��=vi <br /> ARCNILIQ OV OI IGNlN M�II AOORISS CIIY ZIP PNONE <br /> GINLN�I CON�RACIOR MAII ADD0.!$5 UfY LIP YHON! ll[WSF� <br /> NIOInMGI COh1MQON M�II ADOR61 CIIY LIP VNONF � IICENSE 1 <br /> I'IUMq14G(ON/P�QON M�II eODXI$5 C11Y Zi> FNONf IICIN$E� <br /> , C:�55 O�NONK <br /> ❑NEW ❑ADDIiION ❑ALTERATION �REPAIR ❑DCMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RElOCA710N <br /> V�lUAl10N Of N'ORK — � <br /> � �S� G-O <br /> 0I5(N�N RN ` ,�" <br /> �P /�e 27F� f��G�f'i.v � iv 'Y S�Ite r� � f'9' � %/Y�ut.� 5�x� <br /> �worosiouii or juimn+c / �/ / I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br /> �v�yf/ryAF 4 �cc�(��/f�✓T��' / PLICO.TION AND KNOW THE $AME TO BE TRUE AND CORRECT ALL <br /> ieesi oiseAivno�or vaorixrr�snow�u oN ogniucn roun mvitsi PROVISIONS OF LAWS AND ORDINANCES C7VERNING THIS TYPE <br /> � OF WORK WILL BE COMPLIEU WITH WHETHI'R SPECIFIED HEREIN <br /> lUf�PtOC1��Of _ / G� F � OR NOT. THF GRANTING OF A PERMIT DOEL NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCE[ THE rn:1VISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW kEGULATING CONSTRUCTION <br /> ORTHEPERFORMANCEOFCONSTRUCTION. �_��_ <br /> SIG'�ATURf OI CON7RnlTON OR AUTHORIZED ACENT OATE <br /> IOPAOONISS V ��j���i.,� �j�" �/1h5 �%� {) /�.yG.Y1 <br /> `i U f <br /> ►LUMlING MEC ANICAL <br /> NO. TY►E OF FI%TURE FEE NO. TY�E Of EQUI►MENT FEE <br /> WA7[R ClOSET IIOLIETI AIN COND UNI7S—H P U <br /> flA1H7UB N[fNIG[RA710NUNITS—HP EA <br /> UVAIONY�W�S/I BASIN� pOILFRS—N P LA <br /> SMOWfN G�SFINEDAC UNRS—TONNAGEEA <br /> KITCHtN SINK 8 OISP fORC[D AIR SYAEMS—BTU M EA <br /> �ISM'ASMEN \VALlMfA71.X5—�TU M <br /> UUNpR1'iNAi UNI7 MI A710.5-0 T U M <br /> CLOINLS WASN[N CVAPORATI�'C COOLERS <br /> � WAIFRMtAIlN ClO7Mt5�NYCNS <br /> UN�N�I VINIILATION(AN <br /> ORINKING fOUNiAIN NANG[ HOOD <br /> (IOOH ONAIN AIR II�N�LING UNIT— C i M _ <br /> VAQ'UM pRf 1K[NS S70Vt <br /> FOOI �PnIr+S—RAINI f n�f f1$ n1[TAl!INE PUC[ h CH�MNEY <br /> SINK�SEkVICE—PAR.f TC 1 <br /> SU�10T�L SU�TOTAL S <br /> �ERMIT f ff�M1T f <br /> fJ7Ai:� f TOT�IfFE f <br /> SIOFYARDSRBACN STRELTSCTflACY Rf1HYARDSl7BACK PUNCM[U:NUMBIR PUNCHECKfFE <br /> Ff[ rtKEIPT NO. <br /> USE ZON[ LOT AR[A VAUN7 Slif <br /> ❑YES ❑NO fEFS V�lU�T10N iFF <br /> TYP[ O(CONST OCCUPANCV GROUP �'O Of OWEI/ING UNITS <br /> BUILUING y <br /> SIZE Oi BLDG NO Of$TONIIS MAX OCC LOAO <br /> PWM9ING <br /> FlR[ ZON[ BASEMFNT IiIUR(�MS 0.EQUp�IOKlIRS M[CMANIUL <br /> f7YFi ❑NO <br /> ' AMROVAlS �Y D�7E OTMER <br /> 1 ENVIRONM[NTALCM[CKUST P�N^�TY UBC. <br /> SEC ]O7(al <br /> 1. BUIIDING PUNS <br /> TOUI <br /> ) fIR[NYDRANT <br /> � IIRE PNOTEC710N 51'ST[M ►ERMIT V�IID�TION <br /> WMW PNOPERLY VALIDATFD(IN THIS SPACEI THI515 YOIIN PFRMIT <br /> S GNADINGit%UW710NAClLARINL/GRUBPING <br /> • 6 ONA�NAG[ <br /> 1. ENVIRONM[NUL IMPACT STATfMFNi <br /> E MEAITN DISTRIU <br /> APPLICATION ACC.BY PLANS CMFCKED BY �PPN.fOR ISSU�NCE BY <br /> 41�79 <br />