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APPLICATION FOR PYPfP„ <br />`IT,01 iif-JNSTRUCTION <br />everett PERMIT Sui <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 25947I5 <br />EVERETT. WA9P201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />Ow MAII AUORHS CHv _ Pr mull <br />ess Ao k6F- 73�Dsr � e3 3SS- �z 7S <br />MCHITICT ,O,I-R'D1ISIGNIN %/P��� MAII DDRISS I RI lip PHON1 <br />OINIRAL CONTRACTOR MAII ADDRISS CITY lip PROW OCINSII <br />MICHANICAI CONTRACTOR MAII ADDRISS CITY lip PHONE OCINSI <br />PIUMNINC CONTRACTOR MAH ADDRISS CITY lip Pi IICINSE/ <br />11111.1 l... <br />❑NEW ❑ADDITION ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />V'IVAtION Of wONp <br />fIHOII ORA 4L� <br />/.L'^,nD FIVALAI vG. <br />PROPOSIDUSI Of BmLUING _ _ _ _ <br />LICAL DISCRIPTIONOf PROPIRIV ISIIOWN RIIOW OR ATTACH IHUR lOP11S) <br />IOI _AIMK___Uf _ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AN <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 AUTHURITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OLLQtITRACTOR OR AU HORIZED A ENT DATE <br />X 62e� <br />TOR ADONIS SIC <br />f� _ �� �� <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />fit <br />WATER CLOSET(TOLIEY) <br />AIR CONE) UNITS -HP EA <br />BAIIIT'JB <br />REFRIGERATIONUNITS-HP FA <br />LAVATORY [WAS" BASINI <br />BOILERS -HP EA <br />SHOWER <br />GAS FIRED A C UNITS -TONNAGE EA <br />KITCHEN SINK B DISP <br />FORCED AIR SYSTEMS-B T U MIA, <br />DISWASHER <br />WALL HIAIERS-BTU M <br />LAUNDRYTRAV <br />UNIT HIATFRS-BTU M <br />CLOTHI5 WASHER <br />EVAPORATISE COOLERS <br />WATER HEATER <br />CLOTHES DRYIRS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C T Al <br />VACUUM BRIAKIRS <br />STOVE <br />ROOF DRAINS-RAINLE ADE ITS <br />METAL FIREPLACE i CHIMNEY <br />SINK (SERVICE -BAR. FTC) <br />SUB TOTAL <br />PERMIT <br />S <br />SUBTOTAL S <br />PERMIT S <br />I� <br />TOTAL fit <br />S <br />TOTAL <br />F1E F <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD 5f TRACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FIT N <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />fill <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO Of DWELLING UNITS <br />BUILDING <br />S <br />SIZE Of BLDG <br />NO Of STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BAS[M[NT <br />BI DROOMS <br />E SPRR[IDKLERS <br />FIRE <br />IYIS "NO <br />MI CIIAnIC AI <br />J� <br />AP►ROVAIS <br />Rr <br />DATE <br />DTHIN <br />E! <br />1 ENVIRONMENTAL CHECK LIST <br />PINALIY <br />UPC <br />SEC 70XR) <br />E BUILDING PLANS <br />TOTAL <br />1 TIRE HYDRANT <br />A FIRE PROTECTION SYSTIM <br />PERMIT VALIDATION <br />WITS N PROPFRLV VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />S GMDINGIIXCAVATIONACILAKINGIGRUBRINL <br />6 DRAINAGE <br />_ <br />T ENVIRONMENTAL IMPACT STATEMENT <br />E HFAITH OISTRICT <br />ACC BY <br />FAPPLICATION PUNS CHECKFO B1 <br />��. <br />APPR FOR ISSUANCE BY <br />91 79 <br />