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APPLICATION FOP <br />ITYOF .:ONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.6745 <br />EVERETT, WA98201 COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING99 PERMIT N <br />COS ZIP PHONE <br />OWNE0. nn ,/MAIL AOONI55 <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />MAIL ADDRESS sp <br />MAIL <br />ADDRESS <br />ZIP <br />Zd'y <br />PHONE <br />everen <br />e <br />LICENSE <br />jr# -Li -NG <br />LICENSE J <br />S 37?&,Al <br />LICENSE I <br />CLASS OI WORK - <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR []DEMOLITION <br />❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUAIION OF WORK^✓ <br />F <br />011CRIBE WORK T <br />PROPOSED USE DI BUILDING I HEREBY CERTM/i4 <br />T I HAVE READ AND EXAMINED THIS ALL <br />PLICATION ANDTHE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OFND ORDINANCES GOVERNING THIS TYPE <br />LEGAL DISCELP110N 01 PROP(RIY (SHOWN Bl IOW OR ATTACH [OUR CO PII SI / y OF WORK WILLPLIED WI H WHETHER SPECIFIED HEREIN <br />Lot _,__eLoa y�9 Of O/-Je- y� %J� OR NOT. THE G OF A PEk.AIT DOES NOT PRESUME TO <br />GIVE AUTHORIIOLATE OR CANCEL THE PROVISIONS OF <br />-J! t(� ANY OTHER STOCAL LAW REGULATING CONSTRUCTION <br />�iys OR THE PERFOOF CONSTRUCTION. <br />SIGNATURE OF COOR AUTHORIZEDfA�AGGENT DATE ��' ��JOB ADDRESS n ''J/ /.�-H' V ��" ��` <br />PLUMBING <br />NOT TYPE OF FIXTURE <br />BATHTUB <br />LAVATORY (WA <br />SHOWER <br />KITCHEN SINK 8 <br />DISWASHER <br />LAUNDRY TRAY <br />CLOTHES WASH <br />WATER HEATER <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR. ETC) <br />SUBTOTAL <br />PERMIT <br />IRE <br />SIDE YARD SETBACK STREFT SETBA <br />USE ZONE LOT AREA <br />TYPE OF CONST OCCUPANCY' <br />— nl N1 nc NO OF SEGR <br />APPROVALS <br />1 ENVIRONMENTAL CHECK LIST <br />2 BUILDING PLANS —� <br />FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />5 GRADINGII KCAVATION B Cl LARINOGRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />8 HEALTH DISTRICT <br />APPLICAi ION ACC BY PLANS CHECKED 81 <br />9 1-79 <br />MECHANICAiHEAILR5 <br />W <br />NO. mum <br />EQUIPMENT <br />�AIR CP EAREFRS—H P EABOILGAS —TONNAGE EAFORS—B I U M EAWAIU MUNIU M <br />f <br />REAR YARD SI <br />VACANT SITE <br />DYES ONO <br />NO OF DWEL <br />BY <br />PLAN C <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT- C F M <br />STOVE <br />METAL FIREPLACE A CHIMNEY <br />PERMIT <br />PLAN CHECK FEE <br />FEE IRECEIPT NO. <br />G E <br />G <br />ICAL <br />#PERMIT <br />UBC <br />Y SEC J07(al <br />VALIDATIONPROPERLY THIS SPACE) THIS is YOUR <br />PERMIT <br />VALIDATED (IN <br />APPR FOR ISSUANCE BY <br />