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,�PPLICATION Fit <br />4 <br />the CITY OF.FIBE"• - CONSTRUCTIOP. <br />�e <br />CITY <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 <br />EVERETT, WA98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNER MAIL .\ODXFSS <br />CITY ZIP P',ONE 73 3' g0 7 <br />GA <br />%,,e),jSDFa 571 <br />C T 41r <br />Vt,,3 P'L alZSZ- <br />F <br />ZIP PHONE LICENSE IF <br />MLCHANICAI CONTRACTOR MAIL ADDRESS <br />CITY <br />PLUMPING CONTRACTOR MAIL ADORESS <br />LITY ZIP PHON[ LICENSE F <br />CLASS OF WORK <br />❑ <br />ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE SIGN ❑GARAGE BUILDING RELOCATION <br />❑NEW <br />VALUATION OF <br />WORK <br />IFQWi e_ <br />PROPWID USE Of BUILDING <br />L E GAL DESCR I PT N OF PROPERTY(SHOWN BE LOW <br />LOT �BLOCK a,I OF SPIN <br />of-- SAj <br />e: <br />PLUMBING <br />Np, TYPE OF FDI <br />_fiAll-ITUR <br />ATER CLOSET IT.'LIETI <br />SINK <br />TRAY <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS—RAINLIAOE RI <br />SINY. (SERVICE —BAR ETC 1 <br />Icy VLFJ2�7.- C�NF �-1'j <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 />TPI sl PROVISIONS OF LAWS AND CRDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />PRESUME TO <br />IGGIVE OAUTHOR TYTHE ATOING OF AVIOLLATE ORRMIT CANCDELL OES THEOPROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAZY REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION, <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />TYPE OF EQUIPMENT <br />AIR COND UNITS —HP EA <br />REFRIGERATION UNITS—H.P. EA <br />BOILERS—H.P EA <br />GAS FIRED AC. UNITS —TONNAGE EA <br />FORCED AIR SYSTEMS —BTU. M <br />WALL HEATERS—B.T.U. M <br />UNIT HEATERS—B T U M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />•amd&E HOOD <br />AIR HANDLING UNIT— C.F M. <br />STOVE <br />METAL FIREPLACE A CHIMNEY <br />7, T <br />SUN TOTAL <br />TOTAL FEE <br />S <br />YARD SC T BACK <br />STREET 5E T BACK <br />RCAR YARD SETBACK <br />PL� UMBER <br />3 <br />ZONE <br />LOT AREA <br />VACANT SIjk <br />QFO <br />FEES <br />DYES <br />OF CONST <br />OCCUPANCY GROUP <br />NO. Of DWELLING UNITS <br />Ii� <br />AT7P IT N) — $2 <br />BUILDING <br />OF BLOC <br />NO OF STORIES <br />MAX. OCC LOAD <br />PLUMBING <br />E <br />_�—� <br />BASEMENT <br />-- ---- <br />RIDROOMS <br />nNP u�.. ' <br />REQUIRED <br />OYES LbNCAPPROVALS <br />RYONMENTAL <br />CHECK LISTING <br />PLANSHYDRANTPROTECTION <br />SYSTEMINGIEXCAVATION <br />OR <br />B CLLARINGIORUBBINGNAGEIRONMENTAL <br />IMPACT STATEMENTTH <br />DISTRICTICATION <br />ACC BY PLANS CHECKED BY <br />APPR. FOR <br />J+ft I I <br />91 79 <br />MECHANICAL <br />DATE OTHER <br />PENALTY <br />TOTAL <br />BY <br />FEET <br />J <br />UBC <br />SEC TO7(a1 <br />-HECK FEE <br />RECEIPT NO. <br />FEE <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />/ v <br />