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the E"19rRRn <br />CITY OF <br />APPLICATION FOR <br />everett rONTTION <br />PERM <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2594745 <br />EVERETT. WA9e2ot ❑COMBINATICN <br />BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />MAIN 1 MAIL AOONI)S a.^- — ••••'.•• <br />&LA¢Y 4uSfya i5 11L' '+'r tf 3S3 -/040 <br />ARCHITECT OR DESIGNER MAIL ADDRI $S CITY ZIP PHONE <br />GENERAL CONTRACIOR MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE E <br />% X.2 gkPJ rrr i G $?J-/7/T AuP S £ <br />5,voNa.M;,L <br />4R7`lo <br />SGA yL�L <br />7NIPFELC'JD/PE/ <br />MICHANIUL CONTRACTOR MAIL ADDRISS <br />CITY <br />LIP <br />PHONE <br />OCINSI I <br />SAME as rl6Du1` <br />PIUMRINC, CONTRAOOR MAIL ADDRISS <br />CITY <br />ZIP <br />PHONE <br />11(INSII <br />CLASS OF WORK � <br />❑NEW ❑ADDITION ❑yALTERATION Ip REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />YAWAIIOV OF WORK <br />c <br />UI SCRIBE WORx + <br />w, P G �- FtaA1AC <br />N OIL. 1 L <br />PROW)SID LSI of BUIIDIN <br />IIGAI DESCRIPTION OF PROPERTY (SHOWN NILOW OR AIIACHIWRC nH <br />�f <br />[of �e1ocK�_.of PI A �' O C' A e IC - <br />/� <br />,>e,L tene <br />1 HEREBY CERTIFY THAT I HAVE BEAU 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 CONLRACTOR�IOR AUTHORIZED AGENT DATE <br />� G �'1 i � <br />l <br />A Q 1/ <br />P_ <br />Ion ADDRISS <br />t <br />IS 5 L/ EvrcP <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CIOSI7 (TOLIII) <br />AIR COND UNITS-H P EA <br />BAIHIUB <br />RIIRIGERATIONUNITS-TIP IA <br />I AVATORY (WASTE BASIN) <br />HOIII RS-H P EA <br />SHOWER <br />(:AS FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK 6 DISP <br />!OR(! U AIR %)STEMS -BTU MIA <br />DISWASHER <br />WALL HEATERS -BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS -BTU M <br />CIOTMES WASHER <br />I'%APORATIVE COOLERS <br />WATER Hf ATIR <br />CIOTHIS DRYERS <br />URINAL <br />VI MTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />I L(TOR DRAIN <br />MR HANDLING IINIT- CFM <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS -RAINLF ADE ITS <br />ME IAL FIREPLACE IS CHIMNEY <br />SINK(SERVICE -BAR, ETC) <br />I <br />L P <br />SUB TOTAL <br />SUN TOTAL f <br />PERMIT <br />f <br />PENMIT f <br />TOTAL FEE <br />f <br />TOTAL FEE f <br />SIDI VARO SL TBACK <br />STRIA SITIIA(k <br />YEAR )AND St THAI K <br />PLAN CHICK NUMBIR <br />PLANCHICK FIE <br />FIE RECEIPT NO <br />USE ZONE <br />LOT ARIA <br />VACANT Sill <br />CYES ONO <br />FEES <br />VALUATION <br />Fit <br />TV PE Of CONST <br />(O(CUPANCY GROUP <br />NO Of DWELLING UNITS <br />BUILDING <br />S R� <br />L{ <br />.ti ^(, <br />$121 Of BI DG <br />NO OF SIORIlS <br />MAX ITCC LOAD <br />PLUMBING <br />FOR[ZONE <br />BASEMENT <br />111 DIHN)%Il <br />NIQUIREIRI IDKLERS <br />"VIS ONO <br />MECHANICAL <br />J v <br />APPROVALS <br />NY <br />DATE <br />OTHER <br />1 INVIRONMINIAL CHICK LIST <br />PENALTY <br />UPC <br />SEC TONS) <br />2 BUILDING PLANS <br />TOTAL <br />T FIRE HYDRANT <br />I TIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT <br />5 GRADINGII%(AVATIONBCLIARINCfCRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT SIAIEM[NT <br />B HVLTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />91.79 <br />