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;hcErerereEn APPLICATION FOR rett <br />everett CONSTRUCTION' eve <br />PERMIT <br />DEPT, OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA982B7 ❑COMBINATILYN ❑ BUILDING ❑MECHANICAL CIPLUMBING PERMIT NO. <br />OWNIR NVIL ADDRESS CHILIE' PHONE <br />�5%lez L 0/L (o . �150/ 8�1h�/ 1,, S• E . QIME7i � <br />nR T oC oESIGNER�LCyt . �b M.uLAooarss aI(J3 PHONE <br />I�fgO-si-��,1e AID, spG�-I C� <br />, _ EP GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE If <br />Ss- 5I - C- o a-7�C,q- <br />MECHANICALCONTRACTOR MAIL ADDRESS CITY All PHONE LICE NSEN <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 71P PHONE LICENSE N <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE `L[SICN []GARAGE ❑BUILDING RELOCATION <br />VALUATION OF YVORK / <br />S .d <br />DESCRIBE \WORK <br />1C 70 <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HFREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT OATS /�'7/7a <br />y C //}� <br />N...6�C.0.X- JCE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLocK_oF _ <br />LOB //-DR(r�SS/ <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOLIET) <br />AIR COND. UNIHS—H P. EA <br />llTH TUB _ <br />REFRIGERATION UNITS—H P. [A <br />_.,VATORY (WASH BASIN) <br />BOILERS—H.P. CA <br />SHOWER <br />GAS FIRED A . UNITS —TONNAGE EA <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTLNS—B.T.U. M EA <br />DISWASHER <br />WALL HLATERS—BTU. hl <br />LAUNDRY TRAY <br />_ <br />UNIT HEATERS —IT T U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER _ <br />CLOTHES DRYERS <br />—_ <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE FLOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT—C. F AL <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS —RAINLE ADE RS <br />METAI I IREPLACL A CHIMNEY <br />SINK (SERVICE —BAR, ETC I <br />SUBTOTAL <br />SUB TOTAL S <br />PERMIT <br />$ <br />PERMIT S <br />707AL FEE <br />S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SL. TRACK <br />PLAN CFEE K NUMBER <br />PLAN <br />III <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANC)' GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />5 <br />512E OF BIDG. <br />NO, OF STORIES <br />MAX. OCC LOAD <br />PLUMBING <br />°IRE ZONE <br />BASEh1EN1 <br />BI DROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />❑Y[S ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHIR <br />1 ENVIRONMENTAL CHECK LIST <br />'— <br />N NAL71' <br />U PC <br />SI1: 103(a) <br />2. BUILDING PLANS <br />i_FIRE HYDRANT <br />TOTAL <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPI RE Y VAUD NTED DV THIS SPACE) THIS IS YOUR PERMIT <br />5. GRAOINGrI XCAVATION A CLE ARINGIGRUBBING <br />6 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />P HE 11!TI.I NTPIE I <br />