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rhr !i rrr:grrrrF APPLICATION F O R <br />`everett C J NP E R M TT I O N <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 <br />EVEREIT, WA9B201 ❑COMBINATION N BUILDING IJMECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIIF MATT APURISS (:ITS 71P I1D11NI <br />OR DI SN;NIR <br />V2 F <br />1 111 <br />3 . <br />SArn c <br />CENTRAL CONIRM IOK MAIL ADORI IS CITY ZIP PHONE LICINSI F <br />MIOIANIUI CONTRACTOR SHII M)DRISS CITY /IP INTONE LICIN51 a <br />PI UNITING CONTRACTOR MAIL ADDRISS CITY III' PIIONI LION51 R <br />CLASS Of WORK qpI <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN 9GARAGE ❑BUILDING RELOCATION <br />VAIUADON Of WORK <br />T 1 zo? 09, <br />❑i Sf RME WnNN <br />!?,Re ... in IAAM. mn FYisTin. C�nr�nT SCAQ <br />rNu1vNH1I 51 nl Intor," <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO HE 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 />/� <br />X . a, <br />IIGAI DIAL RIPOON OI PROPIRIY (5040WN RHO" OR AITAnl10k N TOP9q <br />LOT/} /B "".fe A DR° RQ baftfr ple V <br />In" ADDRI S5 <br />'7.'AG/ 7fl 6 W ?I? Aos <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />'NAZI R CLOSE I (IOIR TI <br />AIR CONE) UNITS —HP [A <br />BATHTUB <br />RIFRIGFRATIONUNITS—TIP IA <br />LAVATORY (WASH BASIN) <br />BOIL F RS—H P. EA <br />SHOWER <br />GAS I IRED A C UNITS —TON IAGF EA <br />KITCHEN SINK A OISP <br />IORCID AIR SYSTEMS—BT.U. M EA <br />OISWASHER <br />WAIL HEATERS—B.T.U. M <br />LAUNDRYTRAY <br />UNIT HFATERS—RTU M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTIIfS DRYERS <br />— <br />URINAL <br />VENTILATION FAN <br />_ <br />ORINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOT DRAINS —RAINLEAUf IRS <br />ME TAL FIREPLACE B CHIMNEY <br />SINK (SERVICE —BAR. ETC) <br />' <br />SUBTOTAL <br />SUBTOTAL f <br />PERMIT <br />S <br />►FRMIT S <br />TOTAL FEE <br />S <br />TOTAL FIE S <br />SIDI YARD 5I TRACK <br />STRIEI SETBACK <br />RIAR YARDSFIBACK <br />PLAN CI IECK NUMBER <br />PIAN <br />III <br />CHICK HI <br />RECEIPT NO. <br />USE ZONE <br />2_ z <br />101 AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OI NSi <br />OCCUPANCY GROUP <br />M - I <br />NO OF DWELLING UNITS <br />BUILDING <br />5 <br />SIZE Of 01 Dr, <br />6 Y 3 <br />NO OF STORIES <br />1 <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />3 <br />BASfMI NI <br />III HR(N)ALS <br />—r <br />FIRE SPRINKLERS <br />REQUIRED <br />❑YES ❑NO <br />MECHANICAL <br />APPROVALi <br />BY <br />DATE <br />0111111 <br />1. ENVIRONMENTAL CRICK 1151 <br />PI NAI TV <br />U BC <br />SIC 311(a) <br />2. BUILDING PLANS <br />TOTAL <br />i FIRE HYDRANT <br />R FIRE PROTECTION SYSTEM <br />V GRADINGfIKCAVATIONBCLIARINGIGRU11111NG <br />PERMIT VALIDATION <br />WIZEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />I, DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CCFNCKI 1) In <br />Y I e—.1 <br />AI'I'R I )R ISSUANCE BY <br />9 1 79 <br />