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HER EMrgwn A. PLICATION FOR di�YRFR„ <br />GITY'OF CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2598745 <br />EVERETT. WA 98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />NICHIIII('A1 CONTRACTOR MAIL AUI)RISS lily ZIP PHONE HCINS[ R <br />F`H'MRIMI CONTRACWR MAIL AODRISS (IIY ZIP PHONE LICENSER <br />❑NEW..A AA❑ADDITION ❑ALTERATION ❑REPAIR ❑DIMOLITION ❑FFNCF WSIGN ❑GARAGE ❑BUILDING RELOCATION <br />%qkA71O1OFF IF <br />S / � <br />IN', NINE %%O/KRA <br />L.!!)/ W�AdhF /- /4ri J/C Il E'//r�✓ /N SYI ��i.i taw/ /i. ii �� <br />PROPOM I1 FYI OF RURDING <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 THI. PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OI CONTRACTOR OR AU7HORMI., Ali NT DATE <br />UGAI DISCRIPTION OF PROPIRIY ISHO"N moll OR MTMII FOUR COPIISI <br />LOT _RLou_O! <br />lux ADDRI tt <br />PLUMBING <br />MEC ICAI <br />NO. <br />TYPE OF FIXTURE <br />TEE <br />640, <br />TYPE OF FQUIPMFNT <br />TEE <br />WATER CIOSl I T OLIED <br />AIR (ONO UNITS-TIPEA <br />HAT141UH <br />R[IRIGIRAIIONUNITS-HP [A <br />I AVAIORy MASH RASINI <br />NOB I RS -TIP [A <br />SHOW IR <br />GAS FIRED AC UNITS-IONNAGE FA <br />KITCHI N SINK A DISr <br />IORCI D AIR SYSTEMS-B T U MIA <br />DISWASIIIR <br />WALL WATERS -BID M <br />IAUNDRI TRAY <br />UNIT IIIATIRS-BTU M <br />ClOHIR S WASIIE R <br />I AAPORAT IVI COOLERS <br />WATIR HEATIR <br />CIUTIIIS DRIIRS <br />URINAL <br />S'I NIILAIION MN <br />DRINKING FOUNTAIN <br />RANG[ HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C f M <br />VACUUM BR[ AK(RS <br />SIDS'[ <br />ROOF DRAINS -RAINLI ADE RS <br />MITAI IIRIPLACI A CHIMNIY <br />SINK (SERVICE -BAR. ITC) <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />51 <br />PERMIT f <br />TOTAIFEE <br />f <br />TOTAL FEE OF <br />SIDE YARD SO TRACK <br />STRIFE SETRACK <br />REAR YARD SO TRACK <br />PLAN CHICK NUMIRR <br />PLAN <br />ITT <br />CHECK It[ <br />RECEIPT NO. <br />USE ZONE <br />LOT ARIA <br />VACANT SITE <br />OY[S CNO <br />FEES <br />VALUATION <br />FEE <br />TYPE Of CONS( <br />OCCUPANCY GROUP <br />NO Of DWI II INC UNITS <br />OUII DING <br />S j .� <br />s <br />-3 <br />SIZE Of flI UG <br />NO OF STORIES <br />MAX OCC LOADli <br />PLUMBING <br />FIRE ZONE <br />RAS[MIN7 <br />BI IIROUMS <br />FIRE SPRINKIIRS <br />REQUIRED <br />FIVES F1N'D <br />MECHANICAL <br />A►►ROVAILS <br />BY <br />DATE <br />OTHIR <br />1 ENVIRONMENTAL CHECK LIST <br />PE NAT TY <br />TIC <br />SICC NOW <br />SIC <br />7 BUILDING PLANS <br />1 FIR[ HYDRANT <br />TOTAL <br />_S <br />i <br />_ <br />A FIRE PR07IC71ON SYSTEM <br />FERMIT VALIDATION <br />WHIN PROPERLY VALIDA7(D HN THIS SPAC[I THIS IS YOUR PERMIT <br />S GRADIN(ill %(AVA710NACl1 ARINGIGRUNBING <br />6 DRAINAGE <br />7 INVIRONMINTAI IMPACT STATEMENT <br />A HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CH(CKJ IS BY <br />APPLE fOR ISSUANCE By <br />9179 <br />