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APPLICATION FOR PYPF!„ <br />'0"OF "A IN ONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 25"715 <br />❑ <br />EVERETT. WA9e701 []COMBINATION BUILDING ❑MECHANt�AL _ ❑PLUMBING PERMIT NO. <br />MAIL <br />±�1 <br />PL UMRING CONTRACTOR MAIL ADDRESS CITY <br />CLASS OF WORR <br />❑NEW ❑ADDITION ❑ALTERATION ❑ EPAIR ❑DEMOLITION ❑FFNCE ❑SGN ❑GARAGE ❑ BUILDING RE LOCATION <br />VALUATION Of WORK r/ -r7 <br />DjscpT1mI WORK c_) <br />t-4- <br />ftp6sI9451 Of HOLDING <br />I HEREBY CERTIFf THAT I HAVE READ AND EXAMINE THIS AP- <br />PLICATION AND NOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS 06 LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LLGAL AIPOONOf PROPIRIYISHOWN BELOW OR ATTACH FOUR COPIES) <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />Lol97 elof& <br />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 CO TRACTOR OR A SIZED AGENT DATE <br />v � <br />TOR ADO 144 <br />I O � <br />IR <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TY OF EQUIPMENT <br />FEE <br />WATFRCLOSETITOLIETI <br />AIR COND UNITS —HP IA <br />REFRIGERATION UNITS —HP EA <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />flOIIE RS—N P EA <br />SHOWER <br />GAS FIRED AC UNITS —TONNAGE FA <br />FORCED AIR SYSTEMS-8 T U M FA <br />KITCHEN SINK a DISP <br />DISWASHER <br />WALL MEAIERS—BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS—B 1 U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />66THFS DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINK iC fOUN1AIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BREAKERS <br />STGVE <br />ROOF DRAINS —RAINLE AD[ ITS <br />METAL FIREPLACE a CHIMNEY <br />SINK (SERVICE —BAR, ETC 1 <br />SUB TOTAL <br />SUB TOTAL I <br />_ <br />PERMIT <br />F <br />PERMIT I <br />TOTAL Fit <br />F <br />TOTAL <br />FIE / <br />SID[YARD $TRACK <br />STREET SETBACK <br />RIAR YARD SETBACK <br />PLANCHECK NUMBER <br />PLAN <br />CHECK fit <br />Fit <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEI <br />DYES DNO <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />I <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />flI DRWMS <br />TIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />(IYFS ONO <br />APPROYALI <br />BY <br />DATE <br />OTHER <br />I ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC <br />SEC WEEK) <br />TOTAL <br />2 BUILDING PLANS <br />1 FIRE HYDRANT <br />A TIRE PROTF CTION SYST[M <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATEDIIN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINCII XCAVAT ION► CL IARINGIGRUBBING <br />A DRAINAGE <br />PISSUANCIAPPLICATION <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />ACC BY <br />PLANS CHECKED BY <br />