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fM ERPrprPPn A. PLICATION FOR <br />CITY OF CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEV[LOPMENT SERVICES <br />CITY HALL 259 87/5 <br />w <br />EVERETT. WA9R201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />(1WM1I MAII)11R115 /^ TILT /II' pNONf/ /�j// <br />3SZ1 A, E,�Ir.� �S7— vOTo <br />AR ITICT OR PI SIGNER MAIL ADDRI W CITY ZIP PHONE <br />OI `IIReVl Vrv1e410R <br />MAIL ADDRESS <br />CITY <br />lip <br />PHONE <br />LICENSE IT <br />\11114W(q (011RACIOR <br />MAIL ADDRISS <br />CITY <br />lip <br />."IIONI <br />LICENSE IT <br />"I'CH1NY. 101H ACTOR <br />MAIL ADDRESS <br />(IIY <br />ZIP <br />PHONI <br />LICENSE 0 <br />(I All 01 N (IRA ❑N[W ❑AUDITION ❑ALT[RATION ❑REPAIR ❑DEMOLITION ❑FENCE 9SIG1, ❑GARAGE ❑BUILDING RELOCATION <br />\AIL VIfK(IF NOR. ! <br />Il1A(RIR, NURI, <br />L. f Ll-�i�. F� �n e f i. /, e� /7 .•� r e ,(i; // , .f el . I1. <br />rxoposm I sl OI RUROIN(' <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 />SIGNAI URI Of CONTRACTOR OR AUTHORIZED AGENT DATE <br />LFCAL DISCRIPTIONOr PROPHI (SHOWN MIOW'OR ATTACH TOUR COPIIS) <br />101 _RIOCK_OF <br />(ITN AHIIR111 <br />PLUMBING <br />MEC ICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />liqb. <br />TYPE OF EQUIPMENT <br />FEE <br />WAFER CLOSET I TOLIFT) <br />AIR CONE) UNITS -HP IA <br />RAIIOLIB <br />RIIRIr,TRATIONUNIIS—HP EA <br />I AVATORY ON ASH BASIN) <br />ROIL1 RS—H P [A <br />SHOWER <br />GASHIHDAC UNITS—TONNAG( EA <br />KITCHIN SINK A OIAP <br />TOWEL) AIR SNSTIMS—R EU MCA <br />DISWASHIR <br />WM1111ATERS—BIU M <br />LAUNORN TRAY <br />UNIIHIAHRS—B1U M <br />OOTIIIS WASHER <br />IYAPORATI%I COOIIRS <br />WATER HEATER <br />(IOIHIS ORSIRS <br />_ <br />URINAL <br />\'INIILATIONLAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— CIM <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLE ACT RS <br />M17A1 IIRIPLACL ACHIMNIY <br />SINK(SfRVIC(—BAR ITC) <br />SUB TOTAL <br />STIR TOTAL B <br />PERMIT <br />f <br />PERMIT B <br />TOTAL fit <br />S <br />TOTAL FEE f <br />SIDE YARD SE CRACK <br />Si REST AT 79ACK <br />REAR YARD SI TRACK <br />PLAN CHECK NUMBER <br />PLAN <br />ITT <br />CHECK FEE <br />RECEIPT NO <br />USE ZONE <br />IOT AREA <br />VACANT SHE <br />OYES ❑NO <br />TEES <br />VALUATION <br />FEE <br />TYPE Of CONSI <br />OCCUPANCY GROUP <br />NO Of DWELLING UNITS <br />11UIIO.NC <br />� I 1 <br />SIZE OF RLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE BASEMENT BE GROOMS <br />APPROVALS <br />FIRE SPRINKIERS <br />REQUIRED <br />1Y(% []NO <br />ME(HANICAI <br />BY <br />DATE <br />01111R <br />1 ENVIRONMENTAL CHECK LIST <br />PI NAI IY <br />URC <br />AC TDT(a) <br />2 LED TEEING PLANS <br />TOTAL <br />- <br />S TIRE IIYDRANi <br />A FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPLRLY VALIDAIIO (IN ELLI5 SPACE) ULF, IS HOUR PERMIT <br />S GRADINQ1 %C AVAl10N A Cll AKIN :If.RUNBING <br />R DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />A HEALTH DISTRICT <br />April( AIION A(1 rl PLANS CHECXID flv <br />APPR FOR ISSUANCE Hv <br />