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APPLICATION FOR <br />C,JNSTRUCTION <br />everett PERMIT <br />DE PT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 1S"74S <br />EVERETT, WA96201 [:]COMBINATION <br />BUILDING <br />❑MECHANICAL OPLUMBING PERMIT NO. <br />ZIP <br />IpT <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE �'�•^�• <br />CLASS Of WORK <br />❑NEW ❑ADDITION ❑ALTERATION J?REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION Of WORK <br />f <br />n1WRIBE WORK A - _ yl ' <br />D USE Of <br />LEGAL DISCRETION Of PROPERLY (SHOWN BELOW OR ATIACH FOUR COPIES( <br />LOT _BIOCK_OF <br />FOB ADDRESS <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED 1HIb Ar• <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 AUTH�/O/1RIZED AGENT DATE <br />/y <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />AIR UNITS-H P EA <br />WATER CLOSE T ITOIIETI <br />KFFRIGIRCERATION UNITS -HP EA <br />SAINT Ufl <br />flOIlERS-I/P EA <br />LAVATORY (WASH BASIN( <br />GAS FIRED AC UNITS -TONNAGE FA <br />SHOWER <br />FORCED AIR SYSTEMS -By U MIA <br />KITCHEN SINK 8 DISP <br />WALL HEATERS-flT U M <br />OISWASHER <br />UNIT HFATf RS-flTU M <br />LAUNDRY TRAY <br />E VAPORAtIVE COOLERS <br />CLOTHESWASHFR <br />WATER HEATER <br />CLOTHES DRYERS <br />VINTILAIIUN FAN <br />URINAL <br />RANGE 000 <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT- C F M <br />FLOOR GRAIN <br />STOVE <br />VACUUM BREAKERS <br />METAL FIREPLACF 6 CiIMNfY <br />ROOF DRAINS -RAINLFADFRS <br />SUB TOTAL STAL <br />Em <br />S <br />PERMITS <br />IF <br />TOTAL FEES <br />I'IAN CIIICK NU A701R CFE FEE <br />R[PLAN <br />TflACK <br />RI AN IARU SI ItlACK <br />SIDf YA <br />EI <br />FIE RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FE[f <br />VALUATION <br />FEE <br />DYES ONO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO Of DWELLING UNITS <br />IIUHOING <br />y <br />SIZE Of BLDG <br />NO Of STORIES <br />MAX OCC. LOAD <br />NUMBING <br />_ <br />FIRE ZONE <br />BASEMENT <br />ILL I1RfH)MS <br />FRIQUIREIDNKII RS <br />,II�II ANICAL <br />L1Yf5 HNO <br />OTHIR <br />APPROVALS <br />RY <br />DATE <br />1 ENVIRONMENTAL CHICK LIST <br />Iq NAVY <br />UPC <br />SEC 303181 <br />2 BUILDING PLANS <br />TOTAL <br />1 FIR[ HYDRANT <br />J FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />ISIU N PROPERLY VALIDATED(IN iH15 SPACE) THIS IS YOUR PERMIT <br />S GRADINGII XCAVA110N6 CLE ARINGIGRUPI ING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT SIATEMENI <br />B IIIAI IF DISTRICT <br />�- i„ I'I ANA CIIII AIVII <br />