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- . <br /> � <br /> APRLICATION FOR �' everetl <br /> everett C`�NPET�M,C�TION e <br /> DEPT. OF COMMUNITY DE!ELOPMENT SERVICE$ � <br /> CITY HALL 259-874i <br /> EVlRETT,WA98201 �COMEINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNCR MAllAOUNISS CIII' JIP PIIONf —_ <br /> �GNU W, OAP4EN �j7/O W . �LCnr �f.usEi DR, L��siF_� f8�-o3 �S�- 8y$ I � <br /> neeHrtcrT oa oesieHea n+nn nonaiss urr zir ri�oru � �S� <br /> RO�I/ MciJug�Eai 4Assa. 1'7s`�o �et��u- w� ti�. gnTNe��1�Q.9P�o11 ��Q� S- l1102 Z <br /> GENENALCONiRAC10N A1nIL�UDRE55 ❑IP ilP PHONE LlCIr.:E N � <br /> DA�� � G° . ��auso,v /Jyat y� ��.� p2. ���. M+a0.yz�,��e 1J�. �18�'��0 � Sv- �1NW3 0 <br /> ME[IIANIGI CON'RAQOR MAIL�DDRE55 ❑T1 ' l.IP PHOY[ LICENSE t (7 .; <br /> � <br /> U'��lNp.rAl n <br /> PWn�PINC CONTR�ROR MAIL��DNE55 � CI15 ZIY PMON[ LICFNSE N 7' <br /> W. <br /> Vy I11�ci...v � <br /> C�US�S Oi WORK � <br /> I[�NEW ❑ADDITION ❑ALTE�ATION CIREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDIhGRELOCATION�. <br /> VAlUAT10N OF WONK i <br /> � � ��,�• � <br /> OESCRIOF K'ORK <br /> CoNg�R��T �1 �t� �es�nzN�e <br /> raoros�ouscornunowc I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> S 1 N(:L E F 1���� ,R¢-51 O£ u c-E PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL � <br /> IEWI Ot5C0.1PtlON Oi PRO�ERIY ISHOWN PEIOW OR AtTAC!1 OUR COPI6� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE � <br /> � OF WORK WILL B� COMPLI'iD WITH WHETHER SPECIFIED HEREIN <br /> ioT�oioa_or GRQun9n �E'a"`e�" E`np`F-S � �pR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO . <br /> GIVE AUTHORITY TO VIOLATE OR C.4NCEL THE PRCVISIONS OF � <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORM�NCE OF CONSTRUCTION. <br /> x� � -rJ- ^ 2q�4 SIGNATURE Of CONTRACTORJ OR AUTHORIZED ACF�' DATE ; <br /> ioenooREss�`O �J��I, �1VB. W � X ��^"�` �l �JQ.H.Q.�y` <br /> li 3 �`�- �� i <br /> PLUMBING MECHANICAL <br /> NO. � TYPE OF fIXTURE FEE NO. TYPE OF EQUIPMENT FEE '� <br /> N'ATER CLOSET(TOIIET) AIR CONU.UNITS-HP.EA , <br /> 9AiHTUB REFftIGERATION UNITS-H.P. EA ' <br /> LAVALORY�WASHBASIN) ROILERS-HP EA <br /> SHOWER a GAS FINED A.0 UNITS-TONNAGE EA . <br /> KITCHEN SINK 8�ISP. 0 FOHCEU AIR SYSTEMS-O.T U. M EA <br /> DISWASHER (� WALL HEATER$-[7SL. M <br /> UUNDRY TRAY Uhli HEATEftS-0 T.U. M <br /> CLOTHES WASHER D Il'APORATIVE COOLERS <br /> WATER HEA7EA D QATMES DRYCRS , <br /> � URINAL V[MI�qT10NFAN . <br /> OFINKING FOUNTAIN NANGi�. HOOD - <br /> FLOOR DRAIN AIN HANDLING UNI7— Cf At. � <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINIEAUFRS METAL PIREPLACE h CHIh1NFY ! <br /> SINK(SERVICE-9AR,ETCJ <br /> SUB 70TA1 � D SUB TOTAI f <br /> PERMIT S � i PENMIT f <br /> TOTAIiEE f � TOTALFEE S /' <br /> SI�E YAqD SETBACK STRCET SETBACK NEAR YAND SETBALK PLAN CHECK NUMOER PUN CHECK FEE <br /> 7r� �� ��F ? 3E3 �CE RECIPTNO. <br /> . . USEZONE LOTAREA VqUNT51TE /� '� ��S/ <br /> �, . ��S lji:f5 ❑NO FEES VALUATION FEE <br /> TYPE OF COtNS[T. OCCUPANCV GHOUP NO OF DWfLLING UNITS <br /> ��^ �- � / ISUIlD14G S <br /> 512E OP BIDC. NO.OF STORIES MAX.OCC LOnD � �� <br /> Lf..�x$9 ' PWMOINC a <br /> FIRE ZONE BASEMENT ISFU�.N{OOMS FlR[ SPRINKlLNS <br /> 3 \'� "'� CY[SIRkDO AtI.CHANIUI ? � <br /> APPROV�LS BY DATE OTHEN <br /> L ENVIRONMENUL CHECK LIST U.BC. <br /> PF NAUI' SEC. 303(a� <br /> 2. DUILDINC PLAN� <br /> TOTAI .�;fj� O <br /> 3. FIRF HYDRANT ' .,i�,i <br /> 4 FlRE PROTECTION SYSTEM PERMI7 VAUDATION <br /> WHCN PROPF.RIY VALIDATE�pN THIS SPACE)THIS IS VOUR PERMIT <br /> 5 GHADINWfXCAVATIONACLFARINGIGRUflBWG <br /> 6 DRAINAGE <br /> Z ENVIRONMENTALIMPACTSTATENENT <br /> p HfAIT11DIS�HICT <br />