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APPLICATION FOR - <br />�TYOF ,,..ONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />EVERETT, WA98201 ❑COMBINATION El BUILDING <br />MAIL ADDRESS FJ') CIE <br />Z'7 ) PHONE <br />OWNER /��/%/ //I// pl l- I / 4�lie,`e •�R-;f` <br />/ I E I//�1��/ � •TOT 1T7 21P PHOHf <br />LIn <br />UMBING <br />NSE I <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />S v <br />DISCRIBE WORK 1 <br />ence <br />PROPOSED USE Of BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />N AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />LEGALL-DESCRI�ION Of PROPERTY(SHOOWN B <br />EOELOW OR ATTACH FOUR <br />LOTW AHIL1,` BLOCK �' of 1/� o Eve) <br />JOB HillADDRESS <br />I I r�' S� ,�✓ e✓ e / 1 <br />PLUMBING <br />TYPE OF FIXTURE FEE <br />NO. <br />LAVATORY (WASH BA'. <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATER HEATER <br />DRINKING FOUNTAIN <br />FIOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS - RAINLEADERS <br />MINK ISFRVICE-BAR. ETC 1 <br />PROM. IO <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE 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 1HE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />MECHANICAL <br />MFIRFPIACE <br />TYPE OF EQUIPMENT <br />ND UNITS-H P. EA <br />GERATION UNITS-H.P EA <br />RS-HP EA <br />IRED AC UNITS -TONNAGE EA <br />ED AIR SYSTEMS-B T U M EA <br />HEATERS -BTU M <br />HEATERS -BTU M <br />ORATIVE COOLERS <br />HES DRY[R5 <br />ILATION FAN <br />E HOOD <br />ANDLING UNIT- C F MEFu FIRFPIACE 6 CHIMNEY <br />SUB TOTAL <br />PERMIT S <br />PERMIT <br />S <br />TOTAL FEE I S <br />TOTAL FEE <br />S <br />PLAN CHECK FEE <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />FEE RECEIPT NO, <br />51DF YARD SETflACK <br />USE ZONE LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION III <br />DYES ONO <br />TYPE OF CONST OCCUPANCY GROUP <br />NO OWELLING UNITS D <br />BUILDING <br />S <br />SIZE OF BLDG NO. OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE LONE BASEMENT BEDROOMSFIRE <br />REQUIRED SPRINKLERS <br />MECHANICAL <br />DYES LINO <br />APPROVALS <br />BY DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U B C. <br />SEC 3031a1 to <br />2 BUILDING PLANS <br />TOTAL <br />3 FIRE HYDRANT <br />PERMIT VALIDATION <br />TIN THIS SPACE) THIS IS YOUR PERMIT <br />4 FIRE PROTECTION SYSTEM <br />WHEN PROPERLY VALIDATED <br />5 GRAUINGIEXCAVATIONBCEEARINGIGRUBBING <br />B DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />5 HEALTH DISTRICT <br />APPLICATION ACC BY FLANS CHECKED ByAPPR <br />FOR ISSUANCE BY <br />91-79 <br />