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APPLICATION FOR ee <br />CuNSTRUCTION <br />everett -PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICE <br />CITY HALL 259.8745 <br />EVERETT.WA98201 ❑COMBINATION BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />IUWNER MAIL ADDRI SS (111 - JIP PHONE SY� - �o, <br />l7 nrr T 71P o r <br />vl. I iwll 1. W I'll IR MAIL ADD SS <br />LIT, ZIP PHONE LICINSI <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />TIT rn wvRA <br />EK' ❑ADDITION ❑ALTERATION -]REPAIR ❑DEMOLITION NCE ❑SIGN ❑GARAGE BUILDING RELOCATION <br />ALUn"/O/,,4/OF WORK L !U <br />[SCRIBE WORK ITILL �l <br />U <br />I <br />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PROPOSED USE OF BUILDING <br />AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PLICATION <br />OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH W14ETIlER SPECIFIED HEREIN <br />LEGAL ofsc R1rHov or raoPlRrr lsralwN snow OR ArinonouR coPnsl PROVISIONS <br />y/�'',, <br />— cU <br />LOT LOCK <br />OR .JOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />-,&Or <br />GIVE AUTHORITY TO \'IDEATE OR CANCEL THE PROVISIONS OF <br />I��� � .-� � Q <br />ANY OTHER STATE OR LOCAL LAREGULATING CONSTRUCTION <br />W' <br />I <br />F <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />O CONTRACTOR OR AUTHORIZED AGENT DATTE <br />SIGNA URE <br />1011 AllI1Nl c�e <br />y <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF EQUIPMENT FEE <br />FEE <br />NO. <br />TYPE OF FIXTURE <br />AIR COND. UNITS-H P. EA <br />%V All R CLOSET IT 0LII1) <br />RLt RIGERATION UNITS-H P l:A <br />13AIIAIUB <br />BOILERS-H P. EA <br />LAVATORY(WASH BASIN) <br />GAS FIRED AC UNITS-IONN'AGl LA <br />SHOWER <br />FORCED AIR SYSTEMS-B /.0 M I ". <br />KITCHEN SINK A DISI' <br />WALL 11C ATLRS-DLU Si <br />DISWASI+CN <br />UNIT ME ATLRS-EI.LU M <br />LAUNDRY TRAY <br />L VAPORATiI'L COOLERS <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />W AFIR I LATER <br />VENTILATION FAN <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C I M <br />S70VE <br />VACUUM BRLAKI:RS <br />Nit TAT FIREPLACE 6 C111h1NF1' <br />ROOF DRAINS-RAINLI ADi. RS <br />SINK (SERVICI.-BAR, TIC) <br />SUBTOTAL <br />$ <br />S <br />SUB TOTAL <br />PIRMIT <br />PERMIT <br />S <br />TOTAL <br />LEI <br />S <br />TOTAL (If <br />S <br />PLAN CHECK <br />FEE <br />REAR <br />YARD SETBACK <br />PLAN CHECK NUMBER <br />SIDI: TARO SETBACK <br />STRI I T SETBACK <br />ill <br />RECFIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />Itts <br />VALUATION <br />FEE <br />ORES ONO <br />TYPE OE CONSI <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNIII <br />BUILDING_ <br />SIZE OF BLDG <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />- <br />PLUMBING <br />FIRE ZONE <br />BASIMLN7 <br />111 DROOMS <br />FIRE <br />RQUREIDKLI RS <br />MECHANICAL <br />_ <br />OYES ❑NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />t. ENVIRONMENTAL CHOCK UST <br />PI NATTY <br />U C. <br />C <br />SIC. xll(a) <br />2. BUILDING PLANS <br />TOTAL <br />7. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIbATLb (IN THIS SPACE) THIS IS YOUR PERMIT <br />5 GRAOINGIEXCAVATION hCUARINGIGRUBIONG <br />6 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STAIIMLNT <br />B HEALTH DISTRICT <br />APPLICATION ACC=PLANS <br />AI'PRIOR ISSUANCE BY <br />94-79 <br />