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„A. <br />fftE"N” APPLICATION FORCITY lYC,P„ <br />everett OF <br />�JNPERMITTION <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S9-076S <br />EVERETT, WA9B301 []COMBINATION ❑ BUIL_jING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />G <br />OFSICNIR . MAIL ADDRESS CITY zip <br />GINIRAI CONTRACTOR MAIL NOBEL$$ <br />MICHANIUICOMMCTOR MAIL ADOASS CITY !IP PNOM IICF SII <br />PIUMBING CONTRACTOR MAIL ADDRESS CIS) TIP PHONE LICINSII <br />❑ASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION AFFAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />WIUATION OF ..IRK <br />T //oo <br />OISCR IRE WORK <br />s- 4:5! tea—C� <br />PROPOSI0 USI 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 />LIGAI Of SCRIPT 104of PROP[ RTV (SHOWN BIION OR At EACH FOUROIIISI <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />7 0 <br />LBLOCK�OF <br />�` t✓ <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT <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 />. <br />x <br />Ion ADmus <br />< N ST==T <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEf <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOLIET) <br />AIR COND UNITS —HP [A <br />BATHTUB <br />REFRIGERATION UNITS —HP EA <br />LAVATORY (WASH BASINI <br />BORERS-H P EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK 6 DISP <br />FORCED AIR SYSTEMS-B I U M EA <br />DISWASHIR <br />WALL HEATERS -BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS-9I U M <br />CLOTHES WASHER <br />IVAPORA• ECOOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />MNGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKERS <br />SIGNS <br />ROOF DRAINS- RAINLI ADS IRS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK ISIRVICE -BAR. ITC) <br />SUR TOTAL <br />-- <br />SUR TOTAL B <br />_ <br />PERMN t <br />PERMIT / <br />TOTAL I[[ <br />f <br />TOTAI LEI B <br />SIDE YARD SETBACK <br />STREET SITRACK <br />RUN YARD 51 TBACK <br />PLAN CHICK NUMBER <br />PLAN <br />CHECK FFE <br />O <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />TIES <br />vAIUASION <br />fit <br />OYES ONO <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO Of DWELLING UNITS <br />BUILDINC <br />S <br />-34' <br />•j i <br />SIZE Of BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />f IR! ZONE <br />BASIMf NT <br />ITSOR(H)MS <br />IlltI SPPRINKIIRS <br />MECHANICAL <br />HS v0 <br />APPROtAIS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONM(NTALCHICKLISI <br />PI NAl1Y <br />UBC <br />SEC SORER) <br />TOTAL <br />.2 <br />S <br />7 BUILDING PLANS <br />L FIRE HYDRANT <br />,� <br />A FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHIN PROPERLY VALIDATED BN THIS 5PAC'.1 THIS IS YOUR PIRMI I <br />SGRADINGISIAVATIONACIIARIti I.RUBRINC <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT SIATf MINI <br />6 HEALTH DISTRICT <br />APPLICATION ACC By <br />PLANS CHE CKID BY <br />APPA FOR ISSUANCE BY <br />9 179 <br />