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IM EYvpnRn <br />CITY OF <br />APPLICATION FOR,. <br />v..,ONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 254B74S <br />EVERETT. WA 98201 ❑COMBINATION <br />BUILDING EIMECHANICAL ❑PLUMBING PERMIT NO. <br />ntr nr PNONI <br />RYlTlR <br />e <br />PIUMBING CONTRACTOR MAIL AFFORDS CITY ZIP PHONE LICENSE <br />CL ASS OF WORK �' <br />❑NEW ❑ADDITION ❑ALTERATION y�REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VAIUMION at WORK <br />IF ,),Yoe E n 0 <br />DISCRIRE WORK <br />Z• Y /4- <br />- <br />PROPOSIDUST OF BUILOtNC <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 />DC, DISCKIPTIONOF MOP[ MIT ISHOWN III LOW OR ATIACTS TOURCDPIISI <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />N <br />LOT/3 �w��eIOCK�o " l <br />V <br />OR NOT THE GRANTING OF A FERMIT 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 CONTRACTOR OR AUTHORIZED AGENT DATE <br />TOR ADDRISS <br />aoa ` <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FIT <br />NO. <br />TYPE Of EQUIPMENT <br />FEE <br />W All R CLOSE I JTOLIE TI <br />AIR COND UNITS. -HP EA <br />REFRIGt RATIONUNITS-HP IA <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />BOILERS -TIP LA <br />GAS FIRED A C UNITS -TONNAGE [A <br />SHOWL 7 <br />FORCED AIR SYSTEMS-D T U M EA <br />KITCHEN SINK A DISP <br />_ <br />WAIL HEATIRS-BTU M <br />DISWASHIR <br />UNIT HIATERS-BTU M <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />IVAPORATIVI COOLERS <br />WATIR HFATut <br />CLOTHES DRYERS <br />VENTILATION FAN <br />URINAL <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS-RAINLkADIRS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE -BAR. 11C 1 <br />SUBTOTAL <br />SUB IDIAI IF <br />PERMIT <br />f <br />PERMIT IF <br />TOTAL FEE <br />f <br />TOTAL ITT 9 <br />SIDE YARD SETBACK <br />STRFETSLTBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBkR <br />PLAN <br />CHECK If <br />Fit <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />1![f <br />VAl UAt1oN <br />►11 <br />❑YES ONO <br />NO Of DWELLING UNITS <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />BUILDING <br />L <br />--'— <br />SIZE OF MUG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASIMENT <br />RIUROUMS <br />FIRESPRINKLERS <br />Rf <br />MECHANICAL <br />C YI5 ❑NO <br />APPROVALS <br />BY <br />DATA <br />OTHER <br />ENVIRONMENTAL CHICK LIST <br />PENALTY <br />URC <br />SEC TOXRI <br />TOTAL <br />Z BUILDING PLANS <br />S FIR) HYDRANT <br />4 FIRE PROTICTION SYSTEM <br />PERMIT VALIDATION <br />WNIN PROPERLY VALIDATIDIIN THIS SPACII THIS IS YOUR PERMIT <br />