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APPLICATION FOR <br />Cl, <br />everett <br />PERMIT <br />PERM <br />e <br />OF 111 01 COAT MUNII Y DEVELOPMENT <br />SERVICES <br />CITY HALL 259-8745 <br />EVERETT. WA9R201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL PPI.UMBING <br />PERMIT NO. <br />OWNER <br />MAIL ADDRMS (:II VLS <br />r.. <br />_L.CLLMri QntC <br />A]aL� �`%wiO �%3rH-AJc is+c le]F%W4 <br />f6gA0f <br />AR<.IIIIIQ UR I11510 N1 u <br />MAIL Al1UR1 SS ❑IY ZIP <br />PN''O//NI <br />/ <br />/G3r3��j(c ru•� �FAcA/E Agd4r�IJM�{�o//KQ-Al <br />/-r <br />C <br />' ` '.'IN <br />MAIL AIIfIRIN 1111 ZIP <br />MONT <br />IICIN\I <br />Mllln'. IONIRACIUR <br />MATT ADIIRISS tOY 11P <br />P110N1 <br />IIIINV i <br />PIUMBINGCONITACTOR <br />MALT AIRIRISA fi11 ZIP <br />PION1 <br />ININ51 <br />rl ASS M WORK <br />ADDITION <br />❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />.. „11 WORK <br />r <br />❑I SIRAAI N/n!I1 IR\ a J <br />/n7 <br />A <br />I 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 VIOLATIE 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 />x a - y-so <br />', • A.,'It 1(1N ON AII,, It 1, I. R I InnA, <br />/ I <br />• ua _uunl __nr W e n/W' F <br />S�e'fF.,d 8 o..ZN 8 N <br />Ea � M <br />IUII SUDRL SAS <br />VC ✓r-c tf%,JA 71,919 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOW I(LOW T) <br />00 <br />AIR COND LINIIS—IIP IA <br />RAIIIYU13 <br />RF IRICI RATION UNITS --TIP IA <br />I AVAIOR1151 A%H BASINI <br />L70 <br />I <br />BOIIIRS—HP FA <br />AI II1511 N <br />0 <br />GAS HRED A C UNITS-TONNA(.I IA <br />KINHIN SINK& 11111' <br />10WID AIR SYSTFMS-RTU. VIA <br />DISWASHFR <br />WAIT IIIAIIRS-RTU M <br />EAUNORY TRAY <br />VNI71IIAMRS-BTU M <br />CLOTHES WASHI R <br />I %AIN)RATIVI COOLIRS <br />WATER HIAIIR <br />( II)IIIES DR11RS <br />URINAL <br />VINIIIAIION TAN <br />DRINKING FOUNIAIN <br />RANGE HOOD <br />I LOON DRAIN <br />AIR HANDI ING UNIT- C I M <br />VACUUM BREAKERS <br />STOVI <br />IIOOF DRAINS-RAINII AM RS <br />All IAI IIRI PI A('I ACIIIMNIY <br />SINK [SERVICE -BAR, I1(1 <br />SUBTOTAL <br />0 <br />SUBTOTAL S <br />PERMIT 3 <br />PERMIT S <br />TOTAL TFF S <br />O D <br />TOTAL FFF IS <br />SIDC YARD St TRACK <br />SIR! 17 ISE IIIA( K <br />NI AN 1ART) SE IRA( K <br />PI AN t 1111 K NII/MIII R <br />/ <br />PLAN <br />EII <br />�� <br />CHECK FIT <br />RE 4/ BOZO X <br />USE ZONE <br />LOT ANI A <br />Y Al AN I V I I <br />,n LIAR <br />Ills <br />VALUATION <br />FEE <br />TYPE O_I <br />A) <br />OCCUPAN11 CRI1111' <br />3�- 3 <br />NI) nl IA%I I I IN(. ( SI I S <br />I <br />III iI l,lNi, <br />S <br />�� <br />JJ <br />Qv <br />SIZE O/ RLPG C <br />odo x 7-0o <br />D <br />NOI SION I I S <br />1 <br />MAX OCC IOAII <br />— <br />I'I UAIII I•a, <br />FIRE .!ONE <br />RASIMINI <br />III DRInms <br />IIRI SIININKIINS <br />RIOIIIRI D/ <br />11 S ✓•11 <br />AV I IIAN1I AI <br />_ <br />APPROVALS <br />RY <br />DATE <br />uCIIIR <br />I INVIRONKUNTAL CHICK IIST <br />PINAI I\ <br />URIC <br />SIC 10141 <br />le' <br />2 01111 UINf, PLANS <br />I IIRI 10DRANT <br />TOTAL <br />S �' <br />c <br />R TINE. PRO11(11ONS1STM <br />PERMIT VALIDATION <br />WHFN PROPIRLY VALIDATED UN THIS SPACE) THIS IS YOUR PERMIT <br />i <br />s eenulNr. I x nennnv A I u ANIN(. 1,RI nuINI. <br />6 DRAINACI <br />7 INVIRDNMINIM INAPA( 1 SIAIIAIINI <br />A III At IN OIS7RH I <br />APPIWATIONACL BY <br />ANS CHLCKIU BY <br />5/*'G <br />AMEN I(IN ISSUANCI 111 <br />T• <br />