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1MErNprwn A� PLICATION FOR r <br />°�TM°� CONSTRUCTION <br />everett PERMIT <br />OEPT. OF COMMUNITV DEVELOPMENT SERVICES <br />CITY HALL 259-E715 <br />EVERETT, WA90201 �COMSINATION (�BUIIDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />�Tu <br />M�.�, �.�x�b� <br />MAII ADDMI55 <br />� <br />qS�ae <br />ZIV PNONF <br />GtNIN�ICONiqAI'1011 MAl1�DDR155 ❑1Y ZIP PNONE lIC[NSEI <br />�qT�...o�:�nJ, C�. �J,�"� �RIeSt ��nGc�.c�c�tc �174�:�- �3-��S3-its�53' <br />��ICHAnifAl{'OViR�C10R /� IAMIeDUM155 �IfY LIP PHONf I�CFHSEI <br />c� PNi/.:1 Fi c.7 i�' IJ.J _�-�[- CY.I ''� 3iLli�-�% <br />PII'��RNU CUNiq�C100. MMl �DOR65 ltf ZIP PNONF UCENS[ I <br />� \N OI NOPK <br />�Nt1�' ❑ADDITIDN ❑AUFP,ATION ❑REPAIR ❑DEMOLITION ❑PENCE ❑SILN ❑GARAGE ❑BUILDING RELOCATION <br />�ur�unsnrwoe� � <br />' (cJ_�7 <br />U���eixi H�nar. �/ <br />EIZ6CT ��llt,_'�K✓� ���D�� U7�B,• <br />worrniovs� oi nunnwr, I HEREBY CERTIFY THAT I HAVE READ AND ERAMINED THIS AP• <br />IIG4 OIISCNiPIIOv pl VROVIXIY ISNON'N PIION' OR �II`�CN IOI/I�R COPII51 <br />�ol V ,�nUN� � oi �fc��l'Kn�✓I( Nn/h.. <br />L vca� vo� g �C-, s3 <br />wx. nx�a n <br />3!-� �uCCEo./Jvr <br />►LUM�ING <br />NO. TYrE Of FI%TURE <br />W ATE R CLOS! T �T011f 71 <br />AATHTUB <br />I�VATONVIWASN PASIN) <br />SNOK'IR <br />NI7CHlN SI4K 6 �ISP <br />UISWnSHER <br />UUHDRY iqM <br />f�O7NfS W�SH[R <br />WAifR HfATFR <br />URIN�L <br />DRINKIN� /OUNIAIN <br />fIOON DNAIY <br />VANUM BREAKERS <br />POOf ORAINS-RAINLUDfNS <br />VY[IVQVIf{�P10 fTfl <br />iYPE <br />fU�TOTAI <br />rE�M1T <br />TOTAI{E[ <br />STRfF7 SRflACR <br />IOi Ae[A <br />OCCUPANCY GNI <br />NO OF STORItS <br />VAUNi 5111 <br />❑YES CNO <br />v0 Of DWfI <br />L:I�� <br />fl�SCMFN7 � N111ROOMS� �II <br />RE <br />�/MOVAIf �Y <br />1 fNVIRONM(NTAI CHLCK UST <br />7 BUIIDING p��NS <br />7 iB[ MYDRANI <br />� F�REPROT[C11045YSTFM <br />S GNADING�%(AV�1�pN6ClfAR�NGCRtIPNINL <br />6 DRAINACF <br />7 [NVIRONMfNT�IIMP�C7SIATEMENT <br />B HInI7NDISiH1f1 <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />OF WORK \VILL NE COMPLIED WITH WHETNER SPEC�FIED HEREIN <br />OR THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIV�iHORITY TO VIOUi� OR CANCEL THE PROVISIONS OF <br />ANY OTH�R OR LOC�AW REGUUTING CONSTRUCTION <br />OR THE P KFOR CE OF ONSTRUCTION. <br />SIGN�IUN I Q �Ci R OR UTMORIZED AGENT DATf <br />MFCHANIUI <br />ffE NO. TY►E (1F FQUI�MENT <br />�IR COND UNI75—H P fA <br />RfIRIG[BATIONUN175—HP EA <br />AOILfRS—NP EA <br />CAS ! B( D 1 C UNITS— iONNAG. EA <br />IORCfDAIR5Y57EM5—BTU M <br />N'All r.U1lRS—B i U M <br />UNIi11fAiERS—�17U M <br />1�'APORATIV[ COOLFR$ <br />CLO7HfS DRYFRS <br />VLN71LRfION FAN <br />RANGEHOUD <br />AI0. IIANDLING UNIT— C f M <br />S10VE <br />Ml i�l I IRf PL�Cf 6 CHIMNFY <br />DATE <br />OUILDIHG <br />PLUMNING <br />MFOUNIUI <br />OTMFR <br />1•1 NAl l Y <br />ifE <br />!E[S V�WA710N <br />f /�wfM\ � <br />«��� <br />UBC <br />SF[ N7H+1 <br />fEF <br />RECFIPT NO. <br />IF[ <br />2! <br />TOT.� � � 2 ! <br />►[�MIT VAIID�TION <br />WNEN PNOPf RlY VALIO�TFD 11N 71115 SPACE� TNIS 15 YOUR PERMIT <br />�,US �'fY�c.tiC+ r�NJ�T� <br />�'�% Gj��� <br />