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APPLICATION FOR fYlF!„ <br />the 'D LJNSTRUCTION U <br />CITY OF <br />everett PERMIT <br />DEPT Of COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259•8745 <br />EVERETT. WA9R2D1 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />111+ nP Pnovl <br />'_./ /-F3b-i-- <br />'YOo7'Y'Oe/YnU/+S/- <br />AMIU11C10RDIMGNIR <br />NAZI ADDRESS <br />fllY <br />AP <br />PHON[ <br />GINERAI[ONTRACIOR <br />MAIL ADDRESS <br />fm <br />Jm <br />PIIONI IICINSII <br />�yeref/ 73/drs TJ✓C <br />51901, Eve16veeN ln/n✓ <br />Eve�>'i'W✓• <br />98ao3 <br />�53 4/l0/ <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS / <br />Eli / <br />!P.1011 <br />ICIN51� <br />oia3 -/-Ey-fR- Es .!J/PH <br />PIUMEINGCONIRACIOR <br />MAIL ADDRESS <br />(Ill <br />:JP <br />'11011 LICE IS[I <br />Cl ASS Of WORK <br />El NEW ❑ADDITION ❑ALTERATION REPAIR ❑DFMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />\'MUAIION OF AURA <br />S /// ya0.00 d ' <br />- I HAVE READ ANC[ %AWNED T AP- <br />Paovo;unAl or BLmoINa <br />I HEREeY TT T AT <br />' <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />T/�L <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LEGAL OF +( 0111ON W PRpP1Rr16NOMN BUILT+Ilv 1Q 11 <br />rt^.1� <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />I' <br />�_PIIn._ar <br />N <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />lot <br />/ 1 <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE ERFORMANCE OF CONSTRUCTION. <br />SIGN ATLI Of CONE CI R R AUTHORIZED AGENT DATE <br />! / <br />Ij <br />mr, ADDRH) <br />-3 . <br />x <br />MECHANICAL IF <br />PIUMBING <br />NO, <br />TYPE OF EQUIPMENT <br />FIE <br />TYPE Of FIXTURE <br />TEE <br />CLOSE I IIOI I[ T) <br />AIR COND UNITS -HP IA <br />REFRIGERATION UNITS -HP EA <br />B <br />RY (WASH BASIN) <br />BOILERS-H P EA <br />GAS FIRED AC UNITS -TONNAGE EA <br />R <br />It <br />fORCID AIR SYSTEMS-B T U M EA <br />N SINK B DISP <br />WALL HEAIERS-BT U M <br />MR <br />UNIT HIATIII T U M <br />RY TRAY <br />IVAPORATIVE COOLERS <br />E S WASHER <br />CLOTHES DRY[ ITS <br />HEALER <br />VI NIILAHON FAN <br />URINAL <br />PRINKING IOUNIAIN <br />RANGE HOOD <br />AIR HANDLING UNIT- C F M <br />I IOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />VH TAI I IRE PIM 16 CMIAINFV <br />ROOF DRAINS-RAINIE AM RS <br />51NK (SERVICE -BAR. FTC) <br />SUB TOTAL B <br />SUBTOTAL <br />S <br />RRMIT <br />i <br />PERMIT <br />TOTAL fit <br />IF <br />TOTAL ltf III <br />SID[YALED Sf iflACK <br />Si LEI Ii SI [BAR. <br />RE All YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />If[ <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />TIES <br />VALUATION <br />Fit <br />❑YES ❑NO <br />TYPE Of CONST <br />OCCUPANCY GROUP <br />NO Of DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO Of STORIES <br />MAK OCC LOAD <br />PLUMBING <br />FIRC ZONC <br />BASEMENT <br />111 DRl ll lA11 <br />I IRE KLERS <br />REQURED <br />MECHANICAL <br />❑YIS ONO <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />— <br />1 fNVIRONM[NTAL C11EC1. LIST <br />_._ <br />PINAtIS <br />UBC <br />SEC I0NR1 <br />2 BUILDING PLANS <br />TOTAL <br />I FIRE HYDRANT <br />I TIRE PROTECTION SYSTEM <br />'HENi VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACE) 11115 IS YOUR PI RN+rt <br />�/"� I, p <br />/ V / ye>�-lG vyvlz L<! //J/.I-1 <br />S GRADING'[ KCAVATION B CLEARINGfGRUBBING <br />6 DRAINAGE <br />-! ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICIJON ACC BY <br />PLANS CN[CKID flY <br />APPLE IOR ISSUANCE By <br />91-79 <br />