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■/ <br />the Ewrpr"" _ APPLICATION FOR L•,.P1P„ <br />CITY OF CONSTRUCTION <br />everett PERMIT e <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259V4S <br />EVERETT•WA98201 OCOMBINATInN ❑BUILDING ®MECHANICAL LPLUMBING PERMIT NO. <br />OWNIIT !,1 f F'Kit'. <br />�jMAIL ADDRES,S� Clly ZIP PHONE <br />�r,&' /g /. <br />� aA—�1L� �EJPre//, mC/ ?L�n ;-yF�7 <br />ARCHIIICT OR OF MCNI R MAIL AVOR SS CItY I ZIP MOST <br />GINDIAL <br />PHONE <br />❑NEW 181ADDITION CIALTERATION ❑REPAIR ❑OfMOLITION ❑FENCE CDSIGN ❑GARAGE ❑BUIIOINC RELOCATION <br />\ AI W t' )N OI NORK <br />OLS(RIRI WORK /� <br />�:-;/.;/�irro.•7f n4 i.lnn/-1 <'1r')I/P, /:/Y o.A- <br />PROPOSED USE OI NMI INL <br />I HER BY CERTIFY THAT I HA A A D EXAMINED THIS AP- <br />PLICATION AND KNOW THE SA Aj�Q{QRJtECT AlL <br />PROVISIONS OF LAWS AND OR Eiii"` �E,gN�IyG/(H TYPE <br />OF WORK WILL BE COMPLIED WHETHER Sf'E(FIIW EIN <br />OR NOT. THE GRANTING OF A PERM�T({�C1F$ p1OT PRESU�r��yy11L�� TO <br />GIVE AUTHORITY TO VIOLATE OR C L E PRqy ISIOMS OF <br />ANY OTHER STATE OR LOCH [[ttffGULATINC HSTRUCTION <br />OR THE PERFORMANCE OF C�IfUCC� <br />COON <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT <br />AY //S ^�1/11t ! I <br />1ICAI OFZRIPTIo Of PRON TOY PHONN RI ION OR AT TAT" TOUR COPIES) <br />l/I7_ T 7 <br />LOT �RI Otk�_OI <br />r �, <br />a6dY er >�ni� J <br />TOP ODRS <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE Of FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />Fit <br />WATER CIOSFT ITOLIFT) <br />AIR COND UNITS -HP EA <br />BATHTUB <br />REFRIGERATION UNITS -HP EA <br />LAVATOR) (WASH BASIN) <br />B0ILFR5-HP to <br />SHOWIR <br />GASFIRIDAC UNITS-IONNAGf LA <br />KITCH1 N SINK A DISP <br />FORCED AIR SYSTEMS-B I U MIA <br />DISWASHIIt <br />WALL HIM IRS -BTU M <br />LAUNDRYTRAY <br />UNIT HLATERS-BTU M <br />CLOTHES WASHER <br />IVAPORATIVE COOLERS <br />WATER HIATFR <br />CLOTHES DRYERS <br />URINAL <br />VI NI ELATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKIRS <br />STOVE <br />5' <br />ROOF DRAINS - RAIN)FADE ITS <br />METAL FIR(PLACF S C•HIMNFV <br />SINK ISIRVICI -BAR, ITC I <br />SUBTOTAL <br />SUBTOTAL IF <br />•(j <br />PERMIT <br />B <br />PERMIT S <br />TOTAL F[[ <br />S <br />TOIAI Fit S <br />SIDE YARDU IBA(I <br />STREET SETBACK <br />REAR YARD SF TRACK <br />PLAN CHICK NUMBER <br />PLAN <br />FIE <br />CHICK FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />CYFS ONO <br />IFFS <br />VALUATION <br />t[F <br />TYPE OF CONSI <br />OCCUPANCY GROUP <br />NO Of DWELLING ONIIS <br />BUIIDIM. <br />S <br />SIZE Of BLOC <br />HO O' STORIES <br />MA K OCC LOAD <br />PI UMIIING <br />FIRE ZONE <br />BASEMENT <br />BI DR(K)MS <br />ORE !PRINKLERS <br />REQUIRIO <br />C)YIS nNO <br />MICHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U R C <br />SIC !OXRI <br />Z BUILDING PLANS <br />TOTAL <br />S FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHIN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINGIIACAVATION&CLIARINGY,RUBRINC, <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STAIEMf NT <br />R HEALTH DISTRICT <br />APPI ICADON ACC BY <br />PLANS CHECKEDM <br />APPR FOR[SSIAY1111. <br />_I , <br />9179 <br />