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�` PPLICATION F�JR ��«<n <br />crro��� �,QNSTRUCT�ON � <br />�verett PERMIIT <br />DEPT. OF COMMUNITV DEVELOPNENT $ERVICES <br />CITY HALL 259�8745 <br />EVERFTT, WA90201 �COMBINATION ❑ BUILDING ❑MECHANICAL PLUMBING PERMIT <br />OWhER <br />MAllA00KF55 UTY ZIP PMONE <br />Ap[HI1EQ OR �ESIGNER mnll AOORE55 <br />CITY 21P PNONE <br />GfN[R�LCOYiRAC10R <br />MAII ADDRE55 ��t7 ZIP PNONE IICENSE I <br />MtCNn�+IUI COrvt0.�f.t00. <br />MAII ����65 ���7 t�P P����E IICENSE I <br />PlUA101NG COM1iRACiOR MAII ��ORE55 <br />CITY ZIP PNONE IICENSF 1 <br />cuss ov wuxR <br />❑NEW ❑ADDITION <br />VAlUAT1ON Of WONK <br />S <br />p6C0.19E wORk <br />raovosEo us� or emioi�+c <br />❑ALTERATION ❑REPAIR <br />t[GAl �fSCRIP110N Of 4XOPERiV ISNOWN flEION ON AIinCN fOUR COPI[51 <br />lOt �_ PIOCc �� Of <br />IOP ef)UN! 55 <br />PLUMBING <br />NO. TYPE OF F <br />WATER ClOSET ITOLIETI <br />BATNTUB <br />LAVATORY 01'ASH BA9P <br />SHOwER <br />KITCHF4 SINK 8 D151' <br />DIS\VASHER <br />UUNDRY TNAV <br />CLOTHES WASHER <br />URINAI <br />ORINYI4L FOUNTAIN <br />FLOOR DRAIN <br />VANUh1 HNEAKERS <br />ROOF ORAINS—RAINIEADEftS <br />SINK �SFR\'ICE—UAR, ETC 1 <br />SIDF YARD SCT� <br />USE ZONE <br />TVPE OF CONST <br />1L FEF S <br />SCTf1ACK R��p <br />lOi AREA <br />OF <br />❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOGTION <br />FEE <br />VACANT SITF <br />�Y6 ❑NO <br />GROUP NO OF �wEILINi <br />IES MA% OCC IOAD <br />I1fDHOOM16 RFO IREI�NKIER! <br />APPROVALS <br />1 ENVIRONMENTAI CMECK LIST <br />2 BUILDINC PU�'15 <br />; FINF HYDRANT <br />0 fIRE PROTECTION $YSTfM <br />S CR�OINGIfXUW710N6ClfnRINGICRUD0ING <br />6 DRAINAGE <br />1. ENVIRONMENiAI IMPACT STATFMENT <br />s MEALTM DIStRICT <br />APPLIUiION ACC BY PlANS CMEIXED BV <br />9-1�79 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLIC.�TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />pROVISIONS OF LAWS AND ORDINANCE$ COVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITFi WHETHER SPECIFIED HEREIN <br />Of� NOT. THE GRANTING GF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER 57ATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTHACTOR OR AUiMORIZED AGENT DATE <br />MFCHANIGL <br />NO. TYPE OF EQUIPMENT <br />AIR COYf� UNITS—HP. EA <br />REFRIGEF�TION UNITS—HP. EA <br />�OILE0.5- H P EA <br />GAS FIREU A.0 UNI75 <br />W��: HEATRRS—f7 T U <br />UN�T MFATERS-0 T U <br />EVAPORATIVE COOLERS <br />CIOTHES �RYEF$ <br />VENiILAiION FAN <br />RANGEMOOD <br />AIR MANOLING UNIT— <br />STOVE (i-�y^Y(�( <br />MFUL FlREPLACE b CH <br />'�AN CHCCK D <br />I <br />DUILDING <br />PWh1l71NG <br />MECHANIGL <br />!7 I UATE I OTMER <br />�pP{t FON ISSUANCF BY <br />PENALTY <br />TU <br />M <br />M <br />CF <br />EA <br />n1 <br />FEE <br />SUlTOTAL S <br />PERMIT s <br />TOIALFFE f <br />H PL�N CHEIX FEE <br />FEE ftECEIPT NO. <br />VALUATION fFE <br />S <br />UBC. <br />SEC lo)(a) <br />TOUL I � <br />�ERMIT VALIDATION <br />WH[H PftOPERIY VAIIDAiFO UN iH15 SPACE) TMI515 YOUR PEftMIT <br />. � . � , . • •� . � <br />