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ApPLICATION FOR <br />�rEo'°`"" �,aNSTRI�CTION <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />❑TY HALL 359-8745 <br />EVERETT. WA9B201 ��OMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />_ _ ..., nunur. <br />everen <br />e <br />, ,.n �.,.� �D2�1 <br />MAIIADDNF55 /� CIiY ZIP PH N/�r-�� <br />�FCMITECTORO[SiGM0. �� ,�/ I�.',� ^.^` I//� C�G�'i� / J " <br />'`_.-0.SS �'rn-S T 48 ( 2`' �" 1X., ��, j� � n�«�� .. � <br />GENFX�L CONLNeClOR (` - M�II ADORE4 C t ' ��tY r� ZIP '' PHONE � � LICFNSE <br />l\ \\ <br />MICMANIUI C0111R�CIOR <br />mMl ADDRF55 CiIY LIP PHONF IICENSE � <br />VWMPitiL CONiR�QOM1 M�II �DOR65 <br />ULY ZIP PH06E lIC[NSE I <br />:l�S'.Oi wONK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION CIFENCE ❑SIGN <br />o ziee wonR <br />��� x 3 � <br />VROVOSfDUSf Of PWIOING <br />V <br />1� <br />�s <br />� <br />IFGAI OFSCNIFLIJN OI PNOPf RIV ISMOWN BFION' 00. �IUCM IpUN wnu� <br />�o�a�a�K—o��cro `�7'wP 2-� <br />D�or._i <i/-, +v��� �;w��u �� <br />�ODNt55 ` <br />.7 1 <br />PLUMBING <br />NO. � <br />TY�E OF FI%TURE <br />BATNTUB <br />LAVATORY (WASH BASIN) <br />SMOWFR <br />KITCNEN SINK 6 DISP <br />DISwASHER <br />LAUNDkYTBAY <br />ClO7ME5 WASNER <br />K'AT[R MUTER <br />URINAI <br />ORINKING FOUNiAIN <br />FLOOR ORAIN <br />VACUUM NREAKERS <br />ROOF DRAINS—RAINLFAD <br />SINK (SFRVICE—B�R, ETC I <br />SUlTOTAI <br />►fRM1T <br />70TAlffF <br />) SCTBACK 51 FFT 5[T^A(N <br />� 6. ' <br />lOT ANU <br />� � a�� 5 <br />p�57, ,` OCCUPAN�LIOiP <br />r N /'l <br />OF <br />BASF-FNT 11fON.UUM <br />MMOVALf __ <br />i ENVIRONMENTAI CNfCK 115T <br />]. BU�l01NG PLAN$ <br />J FIRF HYDRAN7 <br />1 FIeE i ROTECTION SYRfM <br />�� <br />5 GRADINLIE%CAVANON6ClfARINGIGRUBNING <br />6 P0.AINAGF <br />] FNVIRONMENTAL IMPACT $TATEMFNT <br />❑BLIILDING REIOCATION <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED Tnu nr• <br />PLICATION AND KYOW THE SAME TO 0E TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPF <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEU HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NUT PRESUME TO <br />GIVE �UTHORITY 10 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMAN E OF CONSTRUCTION. <br />SIGNAIUNE� J� RA R OR AU7HOR�ZED ACENT /a t% /�C/ <br />� / <br />!� _�i <br />MECHANICAI <br />FEE NO. TYPE OF FQUI►MEnI <br />nIR COND UNITS—H P EA <br />NEFRIGERATION UNITS—M P EA <br />BOILERS—HP FA <br />WS FlRED AC UNITS—TONNAGE EA <br />FORCE�AIRSYSTEMS—BTL M <br />WAIL HEATERS—USL M <br />UNIT HiATERS—E1 T V M <br />kVAPORAiIVE COOLERS <br />CL07Hf50RYFR5 <br />VFNTILATION FAN <br />kANGfHOOD <br />�AR YARD SFItlA[F <br />��fD� <br />'CANT SITE <br />Vl5 LNO <br />�• <br />) Of OWELLING U <br />A% OC O D <br />IRE SF0.INKLERS <br />EQUIRC <br />.VES O <br />�f OAT[ <br />e Ncn�T�� DiiTRICT <br />APPIICATION ACC BY PLANS CHFCKED BY APPR �OR iSSU�NCE BY <br />AIR MANDLING 4NIT— C F <br />FINE <br />PIAN CII[CK VUMBER <br />s���N <br />SU/TOTAL • <br />►FIIMIT S <br />TOTAI{E[ s <br />pUN CMECK FEF <br />FEE RECEiPT NO. <br />3� �� slyv�, <br />vnuTlnN f[F <br />OUILDING �OD�� ' <br />rwMnu+c <br />MECHANIUL �_ <br />OTMCR <br />UBC <br />PfNAL7Y SfC ]Ol�a) <br />70iAL <br />�FIIMIT V�IIDATION <br />WHEN PNOPERLY VALIDATEO UN INIS SPACE) TNI515 YOUR PFRMIT <br />�,, . � /: .. _ / . , . � .. ' . . . <br />/ <br />( <br />5/ 5. lo� Du E o.� �� <br />�. f'�t__. � r,.� '__._$_-• <br />Y <br />