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, r � <br />PpPLICATION FOR=� ���.�n <br />���"'"" .:ONSTRUCTION e <br />everett PERMIT <br />DEPT OF fOMMUNITV DEVELOPMENT SERVICES <br />CITY HALL 2'9�87A5 <br />EVERETT. WA9B201 �COMBINATION ❑ BUILDING ECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIN MAIIAU�NFSS CRV 21P PNONE <br />hr�l c o�r C:� .(� oc�•f'; :.2`J O:a_ ��(`1"�- � tK'�� t� ,�o �s:JC;' J:a !'-J <��f! <br />vHOHF <br />GINEReICONIR�CIOR MMIADORf55 CitY ZIP PNONE LICEHSEI <br />C �-1i- -- �''�f'1'IQ��.� <br />�"7— � r UIY L�P PHOrvF UCENSE / <br />AIICM�N1UlCONt0.ACfON MnIInODRESS <br />J -�r sG�:.,� <br />PLU.NPwG CONIR�CIOR <br />null npDNf55 UtY 21P FHOHE llC[HSE / <br />C1A550f WORF <br />❑NEW ❑�DDI710N <br />W WnIiON Of WOR[ <br />+ J,�2�,0� <br />DISCRIBI WOPK <br />T�lS�T-riL��D (-� <br />PqOPOSf D USF Of BVIIDIVG <br />❑ALTERATION ❑RFPA�R <br />IFGAI CISCPiPiIOH 01 P0.0VtRtt �SHOWN P[tOW ON nITACM IOUR COP161 <br />� , <br />ioi ],�_eioc�� � ov —�'�-F� �(d-n,.!'-e � <br />..� , i'• i �„ �� <br />109�DDP65 <br />) \7J Z <br />PLUMlING <br />NO. TI <br />WATER CLOSET <br />BATHTUB <br />�� <br />OF FI%TURE <br />LAUNDRV TRAY <br />CL01NE5 WASHER <br />WATER MFATFR <br />URINAL <br />ONINKING FOUNTAIN <br />FLOOR ONAIN <br />VACUUM BRf�KERS <br />ROOF DNAINS—RAINLEADERS <br />SINK ISfRVICE—BAR, ETC 1 <br />SU� TOT <br />►FIIMIT <br />i07A1 F <br />i1DE YARD $CTflACK STFF[T SCT <br />L'SE ZONE l01 ARFA <br />TVPE OF CONST OCCUPANC <br />SIZE OF BLDG NO OF ST< <br />FIRE ZONE BASFMENT <br />AMlOVAIf <br />1 ENVIRONMENTAL CHECK LIST <br />3 BUIIOING PLANS <br />) FIRE MYDRANT � <br />1 FIRE PNOTFC110N SYSiEM <br />5 LRADINGIk%UVATION6QkARINGIGRU9BING <br />6. DNAINAGE � <br />7. ENVIRONMENTAI IMPACT STATEMENT � <br />E. HFALIM OISTRICT <br />AYPUUTION ACC BY PUNS CMECKED BY <br />9.1-79 <br />❑DEMOLITION ❑FENCE ❑SIGN � ❑GARAGE ❑BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I� HAVE READ AND EXAMINED THIS AP- <br />PLICATION A��D KNOW THE SAME TO BE 1RUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN <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 />SIGNAiURF OF CONTRACTOR OR AUTHOp}�{D ACFNT OATE <br />' J <br />�/[ � �� /}� vG o /.P9 <br />v i �.� li�- ��/ /�,! <br />MECHANICAL <br />FEE NO. TY�E Oi EQUI►MI <br />AIR COND UNITS—HP. EA <br />oosev.[aAnnHUNITS—MP fA <br />BOIlERS—MP. <br />CAS FlRFD A C. <br />iORCFD AIR 5� <br />WAIL HEATERS—B1 U <br />UNIT MEATERS-8 i U <br />EVAPOR�TIVE COOlE0.5 <br />CIpTHES D8YFR5 <br />VENTIIAiION FAN <br />RANGfHOOD <br />AIR MANDLING UNIT— <br />f <br />s <br />3[AHYA0.D $ETBACK PLAN CHFC! <br />VACANT 51T[ <br />❑YES ❑NO <br />VO OF OWFILINL UNITS <br />BUILOINC <br />MA% OCC LOAD <br />PWM1101NC <br />�r <br />NNAGEEA <br />U. M <br />M <br />M <br />L FIREPUCE 6 CHIMner <br />su�toi�t f � Y <br />�ERMIT f � ' <br />70TA1 iFE s � � <br />VUMtlER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />FFES VALUATION iEF <br />S <br />MECHANIUL <br />DATE I OTNER <br />APPR iOR ISSUANCE BY <br />PENAIiY <br />UBC <br />SEC.707f+1 <br />iOtAL ' I <br />►[lMIT VAIIDATION <br />WMEN P0.0PERLY VALI�ATEDIIN TMIS SPACE17MI5 �S YOUR PERMIT <br />