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the EP.rpnRn APPLICATION FOR <br /> GTY Of LJNSTRUCTION <br /> everett PERMIT �e <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALF 754.674% <br /> EVERETT.WA 98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNIK Mul AUDRf$S (111 V rNONI <br /> P�s S� L. mo o✓ 91S s7 CLinkfe Zf-- Tio 7 PHONE <br /> AR(()DCI OR DIsIcNu MAIL ADONIS$ Dir ZIF <br /> CINIRAL CONTRACTOR MAR AOORHS (ITV ZIP PHONE LICINHI <br /> 7 <br /> ♦III NANI(AI Q)NiM(IDR MAIL ADUNISS 1111 LII PHONE llClNSIf <br /> Pit%)NTMI(OBTRACIOR MAIL ADDRESS (IIY ZIP PHONE IICINSII <br /> (LASS Of WOR% <br /> ❑NELY ❑ADDITION ❑LLTEIL\TI(14 ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> WLUAIION Of WORK <br /> OF SI Kin(WORK ^ <br /> "v�� k ,A 1 a ��9c <br /> PRn(OMu s oI non DING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> HCA)DE SCA IPUON Of PROM R I I SHOWN 611 OA ON AT TAI II DW E COPIIA PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> LOT_AI(xA_01 __ 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 THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT DATE <br /> wn ADnluss5; <br /> �' -S� � 4-7/CK`7`T" x <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER Cl")SIT(TOLIETI AIR GOND UNITS-HP EA <br /> BATHTUB REFRIGERATION UNITS-HP EA <br /> LAVATORY(WASH BASIN) BOLI RS-H P (A <br /> SHOWER C., SFIRED AC UNITS-TONNAGE IA <br /> KITCHEN SINK A DISP ORCID AIR SYSTEMS-B T U AEA <br /> DISWASHERVrIL HIATERS-BTU M <br /> LAUNDRY TRAY ,NIT Hf ATIRS-BTU M ` <br /> CLOTHES WASHER 1 1%APORATIVI COOLERS <br /> WATER HEAIIR CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINI ING FOUNTAIN RANG( HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- C F M <br /> VACUUM BRI AKERS STOVl <br /> ROOF DRAINS-RAINLIADIRS METAL FIREPLACE 6 CHIMNEY <br /> SINK IS'-RVICE-BAR.ETC) <br /> SUN TOTAL SUB TOTAL E <br /> PERMIT E PERMIT 6 <br /> TOTAL FEL f TOTAL fit E <br /> SIDE YARD SITIIACK STREET SITHACK REAR YARD SE TRACK PLAN CHECK NLMBIR PL AN CHECK FEE <br /> fit RECEIPT NO <br /> USE ZONE LOT AREA VACANT SIZE THE VAI WTION fit <br /> DYES ONO <br /> TYPE Of CONST OCCUPANCY GROUP NO OF DW(ILING UNITS <br /> BUILDING S <br /> SIZE Of BLDG NO Of STORIES MAX IXC LOAD <br /> PLUMBING <br /> FIRE ZONE BASE A.[NI NI UROOMS FIRE PREQUIR INNKLERS ED MECHANICAL <br /> f1YEs (INO _..- <br /> APPROVALS ET DAT! OTHER <br /> 1 1NVIRONMINTAL CHECKLIST Pf NATTY UBC <br /> SIC TOR.) <br /> 7 BUILDING PLANS -- <br /> TOTAL <br /> ) FIRE HYDRANT <br /> 1 FIRE PROIfCTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPAC(I THIS 15 YOUR PERMIT <br /> S GRADINGBXCAVATIONACLIARINGICIIUOOING <br /> A 7RAINAGE <br /> 7 ENVIRONMENTAL IMPACT STATEMENT <br /> 1 <br /> B HEALTH DISTRICT <br /> APPLICAT ON ACC BK PLANS CN[CKED BI APPR FOR ISSUANCE BY <br /> 91-79 <br />