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APPLICATION FOR <br />CONSTRUCTIOI il <br />everet. PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.5745 <br />EVERETT,WA98201 ❑COMBINATION UBUILDING ❑MECHANICAL ❑P <br />GI NIRAI CONIRAC7011 .Men ADDRESS CITY ZIP N'ON[ IICINlf 1 <br />_.i <br />(t As$ Of WORK <br />❑NEW ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑fARAGE ❑BUILDING RELOCATION <br />IAIUAIION OF WORK oL/ <br />1 -7� 00- <br />DIS(RIRI WORK <br />i . 11 ­ill.(10D.(Or�D.-..LAI_)U�-/bAY'Fi7F .i./ia /u OAkRs�7 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PRO" OF DI RUIIDINC <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />ni/1 <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />Hut DI{amnDNol D RD W oR A ACH u coansl <br />y{ <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />tol ystocK—OF <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 CONTRACTOR OR AUTHORIZED AGENT DATE <br />ORAnoMu CV/L/ <br />MECHANICAL <br />PLUMBING <br />F[E <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE Of FIXTURE <br />WAi1R ClO5I11T011[ll <br />AIR COND UNITS -HP EA <br />RURIC[RATION UNITS—P! P to <br />BATHTUB <br />BOIlf0.S—H P EA <br />LAVATORY IWASH RASIN) <br />GAS FIRED AC UNITS—IONSMA IA <br />SHOWIR <br />FORCED AIR SYSTEMS-9 1 U M I A <br />KITCHEN SINK A DISP <br />WAIL HI AIF RS—BTV M <br />NIR <br />UNIT III AiIRS—Ril: SI <br />LAUNDADNDR)TRAY <br />tVAPORAtIVE COOLERS <br />CLOIHIS WASHER <br />CIOTHIS DRYERS <br />WATER Hf ATER <br />VENTILATION !AN <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT- C f M <br />f LOOK DRAIN <br />VACUUM BREAKERS <br />slovt <br />METAL FIREPLACE ACI 6 CHIMNEY <br />METAL <br />ROOF DRAINS -RAINLF WEIRS <br />SINK (SIRVICI -BAR, ITC 1 <br />SUBTOTAL y <br />SUBTOTAL <br />nRMIT IF <br />PERMIT <br />S <br />TOGIt[[ y <br />TOTALFtl <br />SIDE YARD St IRACK STREET SETBACK <br />S <br />Of AR YARD SI TRACK <br />PLAN CHICK FEE <br />PLAN CHI CIS NUMER R Il[ C� R(IFly� 0 <br />8 Z 77 5 <br />USE ZONE <br />LOT AREA <br />S A( ANT Silt <br />ItEs <br />VALUATION <br />FEE _ <br />,IS ONO <br />TYPE OF CONSI <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />y <br />SIZ( OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIX( ZONE <br />BASIMENT <br />BI DR(IOAIS <br />FIREREQSPRINKLERS <br />NKLERSREQ <br />MECHANICAL <br />nYlS nN0 <br />AP►ROVALS <br />ST <br />DATE <br />OTHER <br />I ENVIRONMENTAL CHECK LIST <br />pI NARY <br />UBC <br />SIC $OXA) <br />Z BUILDING PLANS <br />TOTAL <br />S FIRE HYDRANT <br />A FIRE PROTf CTIOH SYSTIM <br />__ <br />,a MIT VALIDATION <br />µ rq N PROPf 0.lY VALIDATED TIN THIS SPACEI INIS IS YOUR PERMIT <br />S GRADINGNX(AVATION&Ct[ARING�GRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT SIATIMENT <br />R HEALTH DISTRICT <br />_ <br />APPLICATION ACC BY PLANS CN[CKkD BY <br />APPR InR ISSUANCE BY <br />