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the E"rgmn --APPLICATION 1`07 R I.Y�Te„ <br />CITY OF CONSTRUCTION <br />everett PERMIT e <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S948745 <br />EVEkETT, WA90Z01 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNER MAIL ADDRISS city ZIP PHONE <br />co,. /5�5 -74 r—` �acte/f 9Boo3 353-/040 <br />AACISOICT OR DtSIGNIR MMI AOORl11 city ZIP PHONE <br />GINIRAI CONTRACTOR MAIL ADDRESS city ZIP PHONE LICFNSF <br />Thare �Al<rs S;d;A,n � O°Ivs7- Co. S.Uolfom;rL� 90290 <br />NLMRINC CONTRACTOR MAIL ADDRI SS CITY ZIP PHONE LICENSER <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION KREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />YAIUATION <br />1 3000•00 <br />DISCRIBI WORK <br />Re - Roo Pew RPAFL 1�NRe� GN NrRS <br />PROPOWDUSI OF BUILDING <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 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 />n ^A ' <br />X` �.J Q Y /- i G- 9) <br />LEGAL DISCRIPTION OF PROPIRTY (SHOWN euoW OR ATIALN IOLIR COPIiH <br />LOT_ZeLOCK? or C <br />I ISTOR +DONIn � <br />7 y U e a e 7t LAJ A. SDD 3 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET DOLIETI <br />AIR CONO UNITS —HP EA <br />BATHTUB <br />REFRIGERATION UNITS —HP [A <br />I AVATORY (WASH BASIN) <br />BOILERS —HIP EA <br />SHOWIR <br />GAS FIRED AC UNITS—TONNAGE[A <br />KI ICHI N SINK L UISP <br />FORCE D AIR SYSTEMS —BTU MIA <br />DISWASHIR <br />WALL H[ATIRS—BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS—B 1 U M <br />CLOTHES WASHER <br />IVAPORATIVI COOLERS <br />WATER MATTER <br />CLOTHES DRYIRS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLF ADEN$ <br />METAL FIREPLACE L CHIMNEY <br />SINK (SERVICE —BAR. ETC I <br />LUX TOTAL <br />SUB TOTAL S <br />PERMIT S <br />PERMIT <br />TOTAL FEE <br />TOTAL <br />FEE f <br />SIDI YARD SETBACK <br />STREET SETBACK <br />RUIR YARD SE TRACK <br />PLAN CHECK NUMBER <br />PLAN <br />Fit <br />CHECK FIE <br />RECEIPT NO <br />USE ZONE <br />LOT ARIA <br />VACANT SITE <br />OYES ONO <br />FFLf <br />VALUATION <br />— <br />fit <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 />MAN OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASIMINT <br />BEDROOMS <br />FIR[ SPRINKIIRS <br />RIQUIRID <br />',IS "'NO I <br />ME'NANJCAI <br />APPROYAIS <br />eY <br />DATE <br />OTHER <br />1 INVIRONMINTAL CHECK LIST <br />rINAIIr <br />UBC <br />SIC SDI(R) <br />I BUILDING PLANS <br />— <br />1 FIRE HYDRANT <br />TOTAL <br />A TIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPFRIY VALIDATED TIN THIS SPACE)THIS IS YOUR PERMIT <br />S rNAUINGIl4CMUTIONLCIk ARINGIGRUflni Ni, <br />N IIRAINACF <br />T ENVIRONMENTAL IMPACT STATEMENT <br />R HIALIH DISTRICT <br />APPLICATION ACC BY PLANS CHECKED BY <br />+ P I'u I ON ISSUANCE BY <br />