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the EY.POMR APPLICATION FC71 a e-_ <br />CITY OF CONSTRUCTION <br />everett PERIMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-6745 ' <br />EVERETT,WA98201 ❑COMBINATION LJ BUILDING ❑MECHANICAL ❑PLUMSit:C PERMIT NO. <br />owNlx / �Y nun AODNI sS CITY 71P PHON: <br />�dvaro� 4/retrs�oylc� ��25 �.P.ypr �G'Pi-1%, <<gJ�ii2a/ ,zf1�.06 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP / PHONE <br />�prrJso /R //rf/7 _i ,zz29 ✓i t/rso. ��ri/.-'S/ .Gw,fl�/1nY 31`.1 <br />. �.ou r �mArme unr •nnRf SS UTY LIP PHONE LICENST <br />CIIANICAL <br />MAIL <br />PHONE <br />I <br />PIVMfH%GCONTRACIOR MAIL ADDRESS CITY NP PHONE LICENSE <br />CI ASS Jr WORK,T--yy <br />❑NEW L'JADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VAIUATION Of WORK <br />5 M,— <br />DISI'RINI WORK <br />A JJ.-/-. ✓ 9_/ rl__.. <br />PROPOSED USI oL RUROINc <br />I/! /""/ w , y C' i- -- <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 TH15 I PE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOLS NOT PRESUME TO <br />OR <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 />SIr,NAIURE OF CONTRACTOR OR AUTHORIZED AGENT DA.E <br />ILGAL OESCRINION Of PROPIII [SHOWN BELOW OR ATTACH IOUR COP ISI <br />����'����� ,^� / ��� fro-�,r�/ <br />LOT G.7""� BLOC YA aw <br />wx <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NA1fR CLOSET {'AtlEi! <br />yY <br />AIR CONIC UNITS-HPIA <br />ILAIHIUB <br />/ <br />.,Cl <br />RURIGIRATIONUNITS-HP EA <br />LAVATORY (WASH BASIN) <br />')C) <br />PIOIIERS-TIP EA <br />SHON'IR <br />LAS FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK A DISP <br />,L' / <br />IORCED AIR SYSTEMS-B T U MCA <br />DISWASIIIR <br />WALL HEATERS-B T U M <br />LAUNDRY TRAY <br />UNIT HEATERS-B T U M <br />CLOTHES WASHI R <br />EVAPORATIVE COOLERS <br />W SEE R HI All R <br />CI OTHI S DRYERS <br />URINAL <br />a% <br />\' I NTILAT ION FAN <br />!1RIn'KING FOUNTAIN <br />I <br />RANGE MOOD <br />I LOOK DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BRIAKIRS <br />STOVE <br />ROOF DRAINS-RAINLLADF RS <br />WEAL FIREPLACE A CHIMNEY <br />SINK ESERVICI -BAR. EEC ! <br />SUB TOTAL <br />`}- <br />:G <br />SUB TOTAI <br />PERMIT <br />f <br />--- <br />PERMIT It, <br />' <br />TOTAL TEF <br />f <br />I I <br />' YJ <br />TOTAL <br />FEF LE <br />SIDE YARD SETBACK <br />STRIET SLTBACK <br />RE -R YARD SE TBACA <br />PLAN CILCK NL'MIHR <br />C/ -79 <br />PLAN <br />It ^ <br />(oa;= <br />(HECK EEC <br />RECEIPT N <br />,may Is <br />US( LONE. <br />�_I <br />LOT AREA <br />t � �U .ATE % <br />VACANT SIIE <br />DYES AND <br />FEES <br />VALUATION <br />Fit <br />O <br />CLl <br />TY ONST <br />OCCUPAN`C-VCRRLO-UP <br />�_z R-.3 <br />NO OF DWELLING UNITS <br />BUILDING <br />S ]C-2L.I"XT IN <br />� <br />VC <br />SIZE SIF BLDG / A <br />028 x SL-'6 <br />NO O STORIES <br />'Z <br />MAX OCC LOAD <br />PLUMBING <br />l 4- <br />lX <br />FIRI ZONE <br />BASEMENT <br />- <br />I BLOROOMS <br />FIRE SPRINKLERS <br />nQSIR[DO <br />CNN <br />MECHANICAL <br />I` <br />LL <br />r, <br />L!( <br />APPROVALS <br />By <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHICK LIST <br />PENALTY <br />UIIC <br />C )DJIeI <br />2 BUBUING PI ANS <br />TOTAL <br />F FIR[ HYDRANT <br />R flRI, PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />� (( r <br />Lr -Th L%%LL . _rD <br />L V <br />L.L Q -(L V 01.-]DA TE aL Ll SC <br />��/�/LI r E' <br />I i� IL uL <br />5 GRADINGIIXCM'AIIONACLEARIN CrGRUNBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATE, <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />V, /' . <br />APPR 1 )R ISSUAhC' NY <br />I <br />91 79 <br />9N bIA, <br />