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r— <br />dle Evergreen APPLICATION FOR ` l Ir PYPTP„ <br />CITY OF r CONSTRUCTIOA lb <br />everett PERMIT - Y <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S"745 <br />EVERETT. WA9B201COMBINATION ❑BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIA ",II ,UOKI SS CIH ZIP 1,14011 <br />MA//c tj;1le,j /.S.2.2 %.?rd. If EUdltff PsJ - ftJF 1. <br />ARCHIUCT OR IL" II II MAR AMIDST CUT, ZIP PHONI <br />PIUMBIM. I UNIIIM toll MAIL ADMITS (II, ZIP �� PHONI UU MIA <br />COLASSOF <br />WDBA NEW❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN YJGARAGE ❑BUILDING RELOCATION <br />VALUATIONOF <br />WWeORRX <br />T rd Vv r <br />DISCRIBI AoRI. <br />UH Of BUILDING <br />LICAL 01 WRIP110N Of PROPI RIY (SHOW BROW OR ATTACH FOUR COMES) <br />LOT .9_RlMK-m2—oF Bark coy$ ADAO� <br />JA4NI G <br />TOR ADORIS <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />WATER CLOSET ITOLI[ll <br />BATHTUB <br />LAVATORY IWASH BASIN) <br />SHOWER <br />KITCHEN SINK A DISP <br />DISWASHER <br />LAUNDRY TRAY <br />CIOTHIS WASHER <br />WATER HE ATER <br />URINAL <br />DRINKING, FOUNTAIN <br />F IOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS—RAINLE AD[ IRS <br />SINK DF RVICE —BAR. ITC 1 <br />SUBTOTAL <br />PERMIT <br />TOTAL LSE <br />SIDE YANDSITBACK STREET SITBAI <br />USE ZONE LOT ARIA cu pspp. <br />TYPE OI CONST OCCUPANCY GROUP <br />AJ M <br />SIZE Of SLOG NO OF STORIES <br />8444 -IF I <br />FIRE ZONE BASF Mf NT NI DN1 <br />APPROVALS <br />1 f NVIRONMEN1AL CHECK LIST <br />2 BUILDING PLANS <br />) FIRE HYDRANT <br />A F IRE PROTECTION SYSTEM <br />S CRADINGIIXCAVATIONACLIANINGIGRUBBING <br />6 DRAINAGE <br />7 INVIRONMINTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY PLANS CHECKED <br />9-1-79 <br />FEE <br />RE ALL YARD SE T BACK <br />VACANT SITE <br />❑YES f m <br />NO OF DWILLINC UNI <br />MAX OCC LOAD <br />RY I DATE <br />RY I APPR IOR ISSUAN(1 In <br />L-c- <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <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 />SIGNAIUBP'0111)NIRACTOR 0.IZFD I DATE Jnp—lp <br />TYPE OF EQUIPMENT <br />, <br />AIR COND UNITS —HP IA <br />REFRIGERATION UNITS—H P [A <br />_ <br />BOILERS —HP FA <br />GAS FIRED AC UNITS —TONNAGE EA <br />FORCED AIR SHTIMS—BTU MIA <br />WALL HLATIRS—BTU M <br />UNIT HLATERS—BTU M <br />1 T APORATIV[ COOLERS <br />I I I) T IH S DRYERS <br />_ <br />VI MTILATION FAN <br />RANG[HOOD <br />AIR HANDLING UNIT— C F M <br />STOVE <br />MFTAI FIREPLACE A CHIMNEY <br />SUB TOTAL s <br />PERMIT S <br />TOTAL <br />fit E <br />IICK NUMBIR <br />/ <br />PLAN 1111E K III <br />FEE -73 RIt IIPI Nn <br />I <br />DIS <br />VALUATION <br />If <br />BUILDING <br />f <br />Is cc <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />Llllt <br />SI( HlBnl <br />TOTAL <br />PERMIT VALIDATION <br />WHFN PROPERLY VALIDATEDIIN THIS S►ACEI IHIS IS YOUR PERMIT <br />