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ERR EYfrommen <br />CITY OF <br />APPLICATION FOR <br />CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S9.874S �yyy <br />EVERETT. WA 98201 17.pGOMBINATION <br />❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />WHIR NAZI AOURISS CITY <br />�p ` TIP PHONE <br />au5 is zva gib S.e'cysRer r tanu. w4y Ey6aeir 410y 2- <br />ARCHIIICTORDISIGNIN MAIL ADDRISS CITY ZIP "FIT <br />CINI RAI CONTRACTOR <br />6"6 <br />MAIL At SRISS CITY <br />ZIP <br />PHONE ❑NSI 1 <br />AHCIIANICAI CONTRACTOR <br />�er3 MGerrAN[•1� <br />MAN ADL1R SS SHY <br />I't /q� AI.uIA :tSGA01/gft <br />lip <br />480z7 <br />PHONI Oti1 N5_ . <br />cfQ-83G0 ae. <br />PIVMflrvf.CONIMC TOR <br />MAIL ADIMISS CITY <br />:+ <br />PNONI S /p <br />�ewsera -�puA11A61.vY4 <br />601 sx. EUAwrff*4 WAY e/&FE'6T1 <br />Ile?" <br />R 0Itlr <br />ass ;L;Z. A�7 <br />CI ASS OF WORK <br />)4NEW ❑ADDITION ❑ALTERATION ❑REPAIR []DEMOLITION ❑FENCE <br />❑SIGN <br />❑GARAGE ❑BUILDING RELOCATION <br />SMVAIIOI WORA <br />4-9oE�-CA'Al� <br />Dp <br />I <br />UHSMflI WORT. <br />�AXiL� r4illlay <br />j��51 6&1GC <br />nOmHDUM or •UnDINc <br />S/siJGPaer /LY J( Es�A/E!UCE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICA1ION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONi 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 />SIG TUTS OT CONTRA R OR AU 2ED AGENT DATE <br />.7Q 7 <br />R . /O"��/" <br />LICAL S�RIPUOV OF PROPIIIIS $10 N BUow OR MIALH IOUR COPOSI <br />EDT BIaA_ol L�E <br />/ <br />!— /Z- 'Z �— lY <br />OFF AO.1Rl Ss <br />, S•1.0 <br />PLUMBING <br />ECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATERCLOSITITOLHII <br />L7i% <br />AIR COND UNITS -HP EA <br />BATHTPB <br />REFRIGIRATION UNITS -HP [A <br />, F_3eg, <br />LAVAIORI (WASH BASIN) <br />BOILERS -HP IA <br />- <br />SHOWER <br />jJ <br />GAS FIRED AC UNITS-IONNAG[ [A <br />KITCHEN SINK & DISP <br />/ <br />(,.i7 <br />FORCED AIR SYSTIMS-BTU AI IA <br />DISWASIIER <br />WALL HEATERS—B T U M <br />— <br />LAUNpRITRAY <br />UNIT HEATERS—B T U M <br />CLOTHES WASHER LI l <br />I VAPORATIVL COOLERS <br />WATER HEATER <br />17, <br />CLOTHESc 15 <br />URINAL <br />VE NTILATION IAA <br />) <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C i N <br />VACUUM BREAKERS <br />STOVE <br />_ <br />_ <br />ROOF DRAINS -RAINLIADERS <br />MI TAI FIREPLACE & CHIMNEY <br />_ <br />SINK IS[RVICI —BAR. I 1 <br />STIFF IOTAI <br />° <br />U <br />SUB TOTAL IF <br />PERMIT <br />1 <br />- <br />►[RMIT R <br />J_ <br />TOTAL FIT <br />f <br />TOTAL <br />111 I <br />SIDE YA RI. STTBACK <br />�. _^ <br />S7RF17 St TOM <br />Z F _ <br />REAR YARD SETBACK <br />2OF'T <br />PLAN CHECK NUMB[ R <br />PLAN CHECK FEE <br />FEE RECEIPT NO <br />USE ZONE <br />I OF AREA <br />VACANT Slit <br />DYfS ❑NO <br />TEES <br />VALUATION <br />FEE <br />TYPF OF CONS) <br />OCCUPANCY GROUP <br />NO OI DWELLING UNITS <br />I <br />BUILDING <br />A/ AiCT <br />yQ <br />Z!�J <br />J <br />Sin ui ni w. <br />NO OF STORIES <br />12- <br />MAX OCC LOAD <br />7 <br />PLUMBINGY <br />p <br />FIRE ION[ <br />_. <br />BASEMENT <br />RE EIROOMS <br />FIRE SPRINKLIRS <br />REQUIRED <br />❑YES wo <br />MECHANICAL <br />APPROVALS <br />BY <br />OAT) <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />UBC. <br />SIC 70XPI <br />7 BUILDING PLANS <br />TOTAL <br />�ZZ <br />I FIRE HYDRANT <br />1 IEEE PROTECTION SYSTEM <br />S GOADING:L XCAVA I ION& CIE ARINGIGRUBRING <br />PERMIT VALIDATION <br />WHIN PROPERLY VALIDATEOIIN THIS SPACE) THIS IS YOUR PERMIT <br />S DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />1 HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANSCH[CkIDRY <br />APPLE FOR ISSUANCE BY <br />91.79 <br />