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, :.,�. <br /> ' ��E,�� � ; � C STRUCYION - ! <br /> �� <br /> ��ev�l'�� PERMIT PERMR No. osos8 �: <br /> ciTrH���zsae�+s � COMBINATION ❑ BUILDINQ ❑ MECHANICAL ❑ PLUMdINO <br /> EVERETT.WA 98207 <br /> 1A�IL PD01�55 <br /> GTY ZIP PHOME <br /> OWNER <br /> Ai1CMITECT OA PESIGNEP M�IL ADDRE55 <br /> GITY ZIG %IONE <br /> MAII ADDRE55 <br /> CITY 21P AIONE LIGENSE I <br /> GENERAL CONTIUCTOR <br /> MECNFNIUL COHTMGTOFi MAIL ADORE55 <br /> CITY ZIP RIOME L�CENSE/ <br /> T�ATIiRAT ('aC F�i1TAMFtiT 1611 CRLNf1 . Crtr iP w��E ��NSEr <br /> MAIL ADDRE+S <br /> PLUMBING COMTRACTOA <br /> CU55 OF WORK <br /> ❑NEW ❑ADDITION �A�TEMT�ON ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN GAMGE <br /> V�LUATiON OF WORK <br /> f <br /> DESGRIBE WOpK <br /> PROPOSED USE OF yU1lDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> PLICATION A�J KNOW THE SAME TO BE TRUE AND CORRECT. <br /> LECaAL DEY.A�PTIONOF PROFERTY(SMOW 6E101:OR RTTPCH FOURfAPIE51 q�L PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> L0T BLOC1—oF HERE NF OR NOWI THEEGRANTING OF AWPERMITRDOESI NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCELTHE PRO• I <br /> CONSNRUOCTION OR THERPERFORMANC�OF CA STRUCT ONING <br /> SIGt1AT' AE OF CONiRACiOR OR AUIHOR2hD RGBIT <br /> D.1! <br /> .roenooaess X � �,(l� 8-11-80 <br /> MECM NIC <br /> PLUMEINO 7YpE OF EOUIPMENT FEE <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. <br /> AIR COND.UNITS—��P EA, <br /> WATER CLOSET(TOILET� REFRIGERATION UNITS—NP.EA <br /> BATHTU� BOILERS—HP.flA. <br /> ;Ayq70RV IWpSH BASIN� GP.S PIR[D AC.UNITS—TONNAGE LA. <br /> SHOWER FORCED AIR SYSTEMS—B T.0 M EA <br /> KRCNEN SINK 8 DISP. 1yALL HLATERS—B T U. �`�' <br /> OISNWASHER UNIT HEATERS—07 U. M <br /> LAUNDRviRAY EVAPORATNECOOIERS <br /> CLOTMES WASHER CLOTH[S�R�ERS <br /> WATEfl HEATER y[NTILATION FFN <br /> UPINAL qANGE HOOD <br /> DRINKING POUNTAIN q�q HAN�LING UNIT— GF M. <br /> FLOOR DRAIN �TQy� <br /> VACUUM BREAKERS MEML FIREPIACF 8 CHIMNEY <br /> qppFORAINS—AAINL[AOERS 1 Water Heater <br /> SINK�SERVICE—BAR ETC.) <br /> SUBTOTAL f _ Z OO <br /> SUB TOTAL pEPM17 f <br /> PERMIT s TOTAL FEE f <br /> TOTAL FEE s PLAN CHECK�EE <br /> $IDE VARD SEi�ACK STREET`ETBACK RLAP VARD SETBACK PLAN CHECK NUMBER qECLIPT NO. <br /> FEE <br /> LOT AREA. VAC�NT SITE FEES VALUATIUN ��EE <br /> USE ZONF ,;Y[5 uIJO <br /> TVPE OF CANSi. OCCUPANCY GROUP NO.OF DWEILING UNITS b <br /> BU�LDING <br /> FIZE OF BLDG. NO.OF STORIES MAX.OCC.��AD <br /> PLUM�ING <br /> FIRE ZONE BASEMENT qE0U1RED KLERS MECNANICAL S OO <br /> C7VE5 ❑NO <br /> � BY DATE OTHEH <br /> �PPROYALS UBA. <br /> 1. ENVIRONMENTAL CHECK USi PENALTY SEC.303�a) <br /> 2. BU�LDINGPLPNS TOTAL S OO <br /> �— <br /> 3. FIRE HYDRANT <br /> PERMIT VALIDATION <br /> d. FIRE PROTECTION SYSTEM WHEN PROPER�Y VALIDATED(M THIS SPACE)THI515 YOUR PERMI7 <br /> 5. GRAOING � 0 O � S O O S.O O � � <br /> B. DM�NAGE 0 <br /> 7. ENVIRONMENTAL IMPACT STATEMENT � � <br /> YO U R RECEIPT � <br /> B. MEALTM DISTRICT , <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOF�SSUANCE BV i H A N K Y O U <br /> 1 ' �MN Y O <br /> ADDRESS FILE <br />