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the EYRrgrow APPLICATION FOR PYPT�„ <br />CITY GP 'ONSTRUCTION <br />everett PERMIT <br />OF PT OF COMMUNITY DEVELOPMENT SERVICES <br />CI1'! HALL 259-874S <br />EVERETT, WA96Z01 [1COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNU AYAI ADORE SS '�CIE\ 71P PNONI <br />F o 7'`h SbrrtP Csr�r� idrld3 35�7 <br />urum(Yrn mMcuu �� _ uul mn, as CITY ZIP PHONE <br />GINIRAI CONTRACTOR MAIL ADDRESS CIT', 71P PHONE LICLNSE 1 <br />YA/I// A OI ��.___ � w�i 'f../A CYY! �f F„_-.-ff OF)ifa S�/v.LL•t� <br />NUMRIN(1 CONTRACTOR MAIL ADDR(AS CITY ZIP PHONE LICENSE 1 <br />CIA" Of WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION Of WORK <br />UISCIFIR WORT ,! <br />x T .XI.//�._.. � /���/rN/..ei /,-.,i , ,ye �i /'�..,dsrs_ <br />14 <br />PRO"tDUsl OF IIURUt%G <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TF 15 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 />LEGAL OLSCRIPDON Of PROPERTY (SHOWN RFIOW OR ATTACH FOUR COP1151 <br />LOI _RIDCK_Of <br />TOP AUDRI� �f L'` / • J(/ <br />,J. �j� <br />7`1E' C <br />►LUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATIR CLOSE I ITOLIETI <br />AIR('OND UNITS -HP EA <br />BATHTUB <br />REIRRARATION UNITS -HP LA <br />IAVAIORY (WASH BASIN) <br />BOIL(RN-TIP EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK 6 DISP <br />FORCED AIR SYSTEMS-B T U MIA <br />DISWASHER <br />WALL HEATERS-81 U M <br />LAUNDRY TRAY <br />1'%0 HEATERS -BTU M <br />CLOTHES WASHIR <br />I%APORATIVI COOLF ITS <br />WATER HEATER <br />CLOTH[$ DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C P M <br />VACUUM BREAKERS <br />STOVE W O <br />ROOF DRAINS-RAINLFADFRS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE -BAR, ITC) <br />SUBTOTAL <br />I <br />SUBTOTAL 1 <br />PERMIT <br />51 <br />PERMIT f <br />TOTAL FEE <br />61 <br />TOTAL FEE f <br />SIDI YARDS[ TRACK <br />STIFF T S( TRACK <br />REAR YARD SI TRACK <br />PLAN CHECK NUMBER <br />PLAN <br />Fit <br />CHECK FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FitsVALUATION <br />F[[ <br />TYPE Of CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE Of BLOC <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASIMENI <br />I1101O1)Sn <br />FIRE IRFIDNKLI RARIQ <br />\ I S C,NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHIR <br />1 ENVIRONMENTAL CHECK LIST <br />PINALTY <br />UBC <br />SEC bRRI <br />Z BUILDING PLANS <br />TOTAL <br />S TIRE HYDRANT <br />I FIRE PROIICTION SYSIEM <br />— <br />PERMIT VALIDATION <br />WIIEN PROPERLY VALIDATEDRN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINGII XCAVAIION 6 CIE ARIN(I GRtD1111N(, <br />6 DRAINAGI <br />7 ENVIRONMENTAL IMPACT SIAIIMENT <br />8 HIALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR ION ISSUAN( I In <br />I <br />11179 <br />