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,�.E�.,,,..� A°PLICATION FOR ���,�„ <br />°'"°` �,ONSTRUCTIO[V <br />everett PERM�T � <br />DF.PT OF COMMUNITY DEVELOPMENT SERVICE$ <br />CITY HALL 259�8745 <br />EVERETT, W� 9BZ01 ❑COMBINATION � BUILDING ❑MECHANICAL ❑PLUMBING PERM17 fd0. <br />OWNlR MAR AUDMt55 �IIY ZIP PIIOHE <br />(�i9LT� N. �a5 S� S�,S 71 ci ��,o...7T ,.1n ..n,_ ..,.,� <br />GENERAI <br />CONfRACiOR <br />mnn �ooniss <br />mnn nuunW <br />♦ DDXE 55 <br />arv <br />i'�� LiP PHOHE �I[FNSEt <br />(Ilv ZIP PNONE LIC[rvSF 1 <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑iENCE ❑SIGN ❑CARACE ❑6UILDING RELOCATION <br />V�WAIION Of NORK <br />� ��nnn. o0 <br />u[s�cuin[ woar: <br />�1e.nocJ[ Y- <br />ruorostuus[ or xmimnc <br />CuJ <br />l[GAl OESCRIPiION Oi PqJP! PIY ISHONN flllOK' OR �ILACM IOUR COPIE51 <br />l01 _ fltOCt _ Of �_ <br />��v�o� �Ar+K D;�. 2 <br />S�k 000. n-oo - tar. /3o S,(, j Es� <br />IOI1 nDURISS � �� <br />�.30 $' i S/ .�"G4:'.�c/% <br />PlUM81NG <br />NO. TYPE Of FIXTURE FEE <br />PATM7U� <br />LAW70RY IWASH PASIN) <br />SMO\YF R <br />KIiCMW SINK 8 DISP <br />OISWASHER <br />LAUNDRViNAY <br />CLOTH6 wASHER <br />WATER HE�T[R <br />IIRINAL <br />ORINY.ING fOUNTAIN <br />iLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF �RAINS-0.AINlEAOfRS <br />SIDF YARO SfT[iAIX � STR[ET <br />ZONE <br />TYPE OF <br />SIZE Oi <br />FIR[ ZOI <br />LOT AREA <br />OF STORIES <br />A��ROVAlS <br />1 ENVINONMENTAI CMEIX lIST <br />Z BUILDING PUNS <br />7 FlriF HYDNANT <br />4 FIRf PHOTECTION SYSiEi . <br />5 GRAOINUf%UVATIONbQfARINLICRUBHING <br />6 DRAINAGf <br />7 ENVIRONMENTAL IMPACT STATEMFNT <br />B MEALTH �ISTRICT <br />i <br />VACANT SITE <br />❑YES ❑NO <br />NO OF DWEILING UNIiS <br />;EQUIRED <br />7YF5 LNO <br />er DATF <br />APP�ICATION ACC BY PUNS CHFCKED 8Y I APPR F00. ISSUANCE 9Y <br />9149 <br />�oyz�) <br />I HER[BY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE ANU CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES COVERNINC THIS TYPE <br />OF WORK WILL BE COMPLIED 4YITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT i70E5 NOT PRESUME TO <br />GIVE AUTHORITY i0 VIOLATE OR CAPiCEI THE PROVISION$ OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORh7ANCE UF CONSTRUCTION. <br />SIGNAIURE Of CONTRACTOH OR AUTHORIZED ALENT OATE <br />NO. TYPE Of EQUIPMENT <br />AIR CONO UNITS—M P EA <br />RErRIGEHAiION UNITS—H P EA <br />�OILERS—HP fA <br />GAS FIftED A C UNITS—TONNAGE EA <br />fORCED AIR SYSTEMS-0 T U M <br />WAILMEATEHS-6TU M <br />UNIt HEATEftS-0 T U M <br />FVAPORA7IVE COOLERS <br />ClO1HE5 DRVFRS <br />VENiIUTION fAN <br />RANGCHOpD <br />AIR HANDLING UNIT— C F M <br />$TOVE <br />I MEUL FlREPUCE 6 CHIMNEY <br />PLAN CHECK NUMBER <br />fFFS <br />PEIIMIi <br />f <br />�6- PI <br />FEE <br />PLAN CHFCK FEf <br />FEE RECEIPTNO. <br />VAWATION iEE <br />�UIIDING S � 6 00 ` <br />PWIdilING <br />MECMANIUL <br />OTHI'R <br />PfNAIiY UB[ <br />SFC. JO7(a) <br />TOTAL <br />�FRMIT VALIDATION <br />WMEN PROPERLY VALIDATED pN iM15 SP10E) TMIS IS YOUR PEMMIT <br />