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,ME»ro� APpLICATION FUR ���,�n <br /> ��n�f C,�NSTRUCTIOI . O <br /> everett PERMIT <br /> DEPT OF LOMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259�8715 <br /> EVERETT,WA9B207 �COMBINAiION ❑ SUILDING ❑MECHANICAL ❑PLUM6ING PERMIT NO. <br /> OWNf0. / M�II�DDMISS CIIY 21P PMONF <br /> /)T1Hl�LV L��L•7i� JlLD L/�J �IXD'Y � <br /> MICNIIICT 011�lSIGNFR M�II�DDRISS Ci}y ZIP PNON( <br /> �-L� � / / / <br /> /—cirr � 7�3 t �c✓�e- ��i c�a �/ /� 1 .35 3- YL� /Q <br /> GENfR�lCON1R�C1011 M�II��ORf55 C11 ZiF IHONf ^" UCFNSE� <br /> �}3�a1- Fo-f3Rv_�'/ T31�-�/I <br /> MIONNIUI CONiRACiOR MAIt�ODIIIS$ CItY 21P YHONt UCENSE I <br /> 1'IUnlryltif,CON1PKiOR MAII�DDR[55 C�1Y ZIP PMONF ��CENSf 1 <br /> CU55O{WONK <br /> ❑NEW ❑ADDITION �AITERATION ❑REPAIR ❑�EMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUIIDING RFLOCATION <br /> \'�IUAl10NOf WO[R <br /> + GDU � <br /> oiscaipi woz <br /> ,t a e t n �- <br /> PPOPO510 USf OI flNIUIrvL I H EBY CERTIFY THAT I HAVE READ AND E%AMINED THI$ AP- <br /> PLICATIOY AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> llWlO(SC111PIIOY Of VXOVfNiY�SHOWN B(lON'OR IiGCN bU0.COPI151 PROVISIONS OF LAWS AND ORDINANCE$GOVERNING THIS TYPE <br /> OF WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> iovt�A�«R�or "� OR NOT. THE GRANTINC OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAW REGULATINC CONSTRUCTION <br /> OR THE PEKFORMANCE OF CONSTRUCTION. <br /> SIGNAIURE OF WN70.ACTOR OR AUTHORIZED AGFNT D�TF <br /> IOP�DDIIf15 y <br /> � 0 A <br /> ►IUM�ING MECNANIGI <br /> NO. TY�E OF fltiURE FFE NO. TYVE OF EpUI►MFNT FEE <br /> W�TER ClOSFT ITOUETI AIR COND UNITS-M P EA <br /> �� BATHTUB REFRIGERATIONUNITS-NP fA <br /> UVATORY�WASH PASIN� BOILFRS-H P U � <br /> SHOwER WS RRfD AC UNI15-TONNALE FA <br /> I� KI7CHEN SINK 8 DISP IORCED AIN SYSTFMS-B T U M FA <br /> DISwASMER wAlIHfATERS-BT.U. M <br /> � UUNDRV TRAY UNIT MUTERS-B i U M <br /> ClO7NF5 WASHFR EVAPORATIVE COOlERS <br /> � WAiER HEATfN CIOTHFS ORYERS <br /> URINAL V[NTIUTION fAN <br /> ORINKING fOUNTAIN RANGF MODO <br /> FIOOR ORAIN AIN MANDLING VNIi- C.f M <br /> VACUUM 9NE�K[RS SIOVE <br /> ROOF DNAINS-RAINIE ADf RS M[TAL F IREPLACE 6 CHIMNf Y <br /> SINK�SFRVIIE-BAN.ETC 1 <br /> SU�TOTAL SU/TOi�I 1 <br /> rE�M1T f ►[IIMIT � <br /> 4 TOTALIFF f TOT�l1EE � <br /> SIOF Y1NO SRO�CK $TR[R S[TflACK RUN YAND SETflAIX PUN CNICK NUMtlER PLAN CMECK fEE <br /> FtE NFCFIPTNO. <br /> � <br /> USE ZONF lOT AREA yAGNT SIIE <br /> �VfS CNO FEFf VAlU�710N I[! <br /> TYPFOFCONST OCGUPANCYCROUP NOOFDWfLLINGUN175 <br /> eunomc + <br /> SIZE Of 9LDG NO OF STORIES MA% OCG IOA� <br /> PWMOING <br /> NR[20N[ B�S[MENT IIIUXOOMS R QU REI�NKlENS M[CMAMUI <br /> f1YF5 CNO <br /> �►►IIOV�lS �f UAT[ OTN[H <br /> 1 ENVIRONMWTAICHECKLIST PlNAL1Y U9C <br /> 5[C ION+I <br /> 2 BUIIUING PUN$ I <br /> TOTAL <br /> 7 FIN[ HY�RANT <br /> � flRf PROTFCTION SYTTfM ►E�MIT VALIOATION � <br /> WHCN PROPENLY\'ALIDAI[D IIN iM15 SPACq iMIS IS YOUI'PFRMIT � <br /> 5 GNADINGII%U\'�TIONbCUARINGIGRUAflING <br /> 6 DRAINAGF � <br /> J [NVINpNMFNTAL IMP�C7 STATfMFNT II <br /> p HUITII DI'iFICi _ _ __ _.. J <br />