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, <br />0 <br />fMEwrym� 1PPLICATION FO"' <br />��ry�F CONSTRUCTION <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SiRVICES <br />CITY HALL 259�87�5 <br />EVERETT. WA98701 ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />own[n Mnn nooxess cnr Ziv vnonE <br />�Hc�� �1 N,�aaa� 3�« ao,—! s; Ev�R�rr 9��oi ,��.� -�9�r/ <br />I.RCNIitCTOR�fiIGNtq MnIIADDRl55 CILY ZIP PHONE <br />GENER�t [ONLX�C�OR M�I: nDDN65 Ciie ZIP PXONF UCFMSE I <br />mEU1nNIUlCONiFAQOX nlnllAD�R[55 UiV 21P PMOMf IICENSE� <br />PIVMNInGCONLRAf.iOR MAIIA�UP65 C:iY ZIP PHONf IICEN5E1 <br />CU55Uf WOdK <br />❑NEW ❑ADDITION ❑ALT[RATION REPAIR ❑DEMOIITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RFLOCATION <br />VAWAIIONOf WORR � - <br />�_�O . _ ., G d <br />WUNA <br />PNOPOSfO US( Of PW Wlrvc <br />Ffo �n� <br />IEGAI Df$CRIviION Of VROPfRiT ISIIOWM1 HFIOW OR AIiACH IOIiX COPIf51 <br />101�_BIOCK�04 .S% N�LHpLA�S /YDO� <br />IOH e0LAL55 <br />PlUM81NG <br />Np, TYPE OF FI%TURE <br />WATEN CLOSFT ITOIIETI <br />OATHTUB <br />KITCHFN SINK 6 OISP <br />DISwASMER <br />LAUNDRV TRAY <br />CLO7NF5 wASMfR <br />WAfER HFATER <br />URINAI <br />URINKINC fOUNTAIN <br />fLOOR DRAIN <br />VACUUM BREAKERS <br />ROOf DRAINS-RAINLEAO <br />SINK ISERVICf - BAR F TC 1 <br />YARD <br />ZONE <br />TYPf Of C( <br />SIZE OF tlL <br />FIRF ZOYE <br />►ERMIT � <br />iOTA1iEE s <br />STRFFT SCT9Afr, BCA0. <br />LOT ANEA <br />OCCUPANCY GR( <br />NO OF 5T00.1f 5 <br />BASfMENT NI <br />A►►�OVALS <br />1. ENVIRONMENTAL CHECK 115T <br />1. CUILOING PUN$ <br />7 FIRE HYDr2ANT <br />� fIRE PROTECTION SYSTEM <br />5 GRADINGf%CAVATIONBQfARINGILRUBBINC <br />6 DRAINAGE <br />7. FNVIRONMENTAL IMPACT STATEMENT <br />B. HEAITH OISTRICT <br />VACANT SIIF <br />❑1E5 ❑NO <br />NO OF DWEL <br />MA% OQ lC <br />'IRE �7HINKL <br />�Y <br />DATF <br />ePPUGTION ACC. BY PlANS CHECKED BY I �PPR FOR ISSU.�:�CE BY <br />41-79 <br />I HEREBY CERTIFY THAT I HAVE READ ;�:'JD EXAMINED THI$ 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 $PECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VInLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LUCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE'JF CONSTRUCTION. <br />SIGNATVRE OF CONTRACTOR OR AUTMORIZED /�GENT DATE <br />MECHANICAL <br />NO. TYPE OF EQl <br />AIRCOND UNITS-HP EA <br />.,..����o..�nu � iurtc _ u <br />PLAN <br />BCILkHS-HP EA <br />Gn5 SIRFD �C UNITS-TONNAGE EA <br />FORCED AIR SYSTEMS-8 TL M EA <br />N'ALINEATERS-IiTU M <br />UNI7HEATERS-NTU M <br />VFN7ILATION IAN <br />RANGE HOOD <br />AIN HANDIING UNIT- C.F M <br />STOVE <br />METAL RREPLACE 8 CHIMNFY <br />FF[5 <br />SU6 TOTAL <br />FFE <br />� <br />f <br />S <br />PUN CHKK iEE <br />I RECEIPT NO. <br />IiU1LDING S S�v <br />YWM9ING <br />MFCNANIUL <br />OTMER <br />P[N.�LTY U.BC. <br />SEC. 30Ha� <br />TOTAL <br />►ERMI7 VALIUATION <br />WMEN PROPERLY VALIDATEC IIN TMIS SP�CE) TMIS IS YOUN PERMIT <br />� <br />