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11,FY ArAPLICATION FOR <br />fV� <br />`ITY OF CONSTRUCTION <br />everett PERMIT <br />OI PT Of COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-87/S <br />EVERETT. WA9B701 XCOMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PEWIT NO. <br />�ccis ,Lh»,�s sum au� sAFMcv�Ru•7 �//Au• w7+y EyErr�r/ PHONE <br />ARCHITICT ON OLSIGNIR MAIL ADDRISS CITY 7111, PHONE <br />CITY ZIP PHONE }_ <br />MAIL <br />�LVMNItif. CON1RAClOR MAIL ADONIS$ CITY ZIP PNONI D� p 1^SNP <br />o�fAlSdU A:94&V N4 &6? s E etldw r iI c✓AY Evewa MOO 3 7-�ni <br />CI 5f OT WORK <br />{EW ❑ADDITION ❑ALTERATION ❑REPAIR []DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />W1VAtION OI WOR4 <br />DISTRITO WORK <br />c51/V6GEC 6*I jI A?�Si Jdu�E <br />PROPOSED USE Of PUT, DING <br />�NG -u X—/�±C(� <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 />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 />TUR I C///O''IINTRA OR O/1} AU Z[D AGENT DATE <br />k /- a - `) �✓ <br />Cg" <br />ILGAI DISGIPTIONOF PROPIRIYISHOWN BIIOW OR AITACH TOUR COPIISI <br />y ETCRGEN6 C717�'3 <br />Lot Pao eLocK�ur <br />• <br />I <br />ION ADDRI55 -7 j <br />PLUMBING <br />ECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATT R CLOSI T ITOLI[TI <br />AIR CONE' UNITS -HP [A <br />BATHTUB <br />[7 <br />REFRICE RATION UNITS -HP EA <br />LAVATORY (WASH BASINI <br />? <br />BOILERS-I/P EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />k I7CHIN SINK 6 U15P <br />�'J <br />FORCE D AIR SYSTEMS-B T U M EA <br />DISWASHIR <br />^ <br />C <br />7i= <br />WALL MAIERS-BTU M Qo <br />LAUNDRY TRAY <br />UNIT Hf A11RS-BTU M <br />CLOIHIS WASHFR tbA'6((7 OA)t <br />[. <br />IVAPORATIS'I UULERS <br />WATER HIATIN <br />CLOTHISORYIRA Amoguio 0 <br />URINAL <br />VEA TIV�T ION 1 AN <br />' <br />DRINKING FOUNTAINIF <br />RANGE HOOD <br />[j <br />FLOOR DRAIN <br />AIR HANDLING I NIT— C F M <br />VACUUM SRI AK I RS <br />SIEVE <br />ROOF DRAINS-RAINLEADE INS <br />METAL FII I I A CHIMNEY <br />11%K (SIRVICI-BAR. FTC 1 <br />SUB TOTAL <br />U <br />SUB TOTAL I <br />'U <br />PERMIT <br />IF <br />►[RMIT S <br />- <br />TOTAL FEE <br />S <br />TOTAL <br />TEE S <br />SIDE YARD SF I BACK <br />51 1SETBACK <br />REAR YARD $E TRACK <br />PLAN CHECK NUMBER <br />k 2 C7 <br />.•T III PLANCHICK <br />Fit <br />FEE <br />REPT NO <br />USE ZONE <br />IOT AREA <br />VACANT SITE <br />:1YES CNO <br />FEE! <br />VALUATION <br />Fly <br />TYPE OF CONS? <br />N <br />OCCUPANCY GROUP <br />K 3 <br />NO OF DWELLING UNITS <br />1 <br />BUILDING <br />I <br />2A <br />SIZE OF BLDG <br />19BA y F <br />NO OF STORIES <br />I <br />MAX OCC LOAM <br />S <br />PLUMBING <br />�7 <br />!�4 <br />FIRE ZONE <br />BASEMENT <br />IIIIIWI� i•.I <br />TIRE SPRINKLERS <br />REQSIRIDn <br />�d <br />MECHANICALlYF <br />'•]•w' <br />[• <br />A►►ROVALI <br />It <br />DAIT <br />OTHER <br />1 ENVIRONMENIALCH[CK LIST <br />PENALTY <br />USC <br />SEC 70RU <br />7 BUILDING PLANS <br />TOTAL <br />C� <br />2 <br />L) <br />I FIRE HYDRANT <br />A FIRE PROTECT104 SYSTEM <br />PIRMII VALIDATION <br />WHEN PROW +ALIDATED TIN THIS SPACII THIS IS YOUR PERMIT <br />I (J <br />5 GRADINGII XC AVAT ION& CLI ARINGICRUBBING <br />6 DRAINAGT <br />7 ENVIRONMENTAI IMPACT STATEMENT <br />6 HIALTH DISTRICT <br />APPLICATION ACC BY <br />(,c7 <br />PLANS CHECKED BY <br />P lj /1, <br />APPR FOR ISSUANCE lO <br />L • c <br />9.1.79 <br />