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fMEYwpnBn APPLICATION FPR <br /> CITY DP L CO P RM TTIOI. Ll <br /> everett <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 2SM74S <br /> EVERETT.WA 98201 EICOMMBBIIIN/EA�TION ❑ BUILDING LIMECHANICAL ❑PLUMBING PERMIT NO. <br /> 1 - �j I�SO MAI !7F <br /> }y / ,S , CI f �I� //D .ROIs - /ST cf- <br /> e� G/3 J� <br /> ARCHITIC R DI SIG NlR All D9RlSS CITY IP N! <br /> �A) M:6p� (65/7 <br /> CI NI RZl <br /> AI CONIRMAIL AD RQ ISS CITY IIP PHONE LICENSE L <br /> MIC A ICAL CONTRACTOR MAIL ADDRESS CITY IV PHONE LICENSE S <br /> PI VMRINC.CONIRACIOR MAIL ADDRESS CITY [IP PHONE LICENSE <br /> CLASS 1 WORK <br /> NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> VAIUArpN Of WORK C)9) <br /> o1sl11BL K /•J'� <br /> PROrosIDUSE Of RUILOINC I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> No(SGIPTION OI MOPLRIv 0y—DwOW OR ntrecH IouR rnsl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> 1 / eLLxK Dr1!5,7'.v <br /> 4z 7 OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> 1 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 /> t1 , OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONTRACTOR OR AUTHORIZ -ACENT DATE <br /> EOR ADDRESS <br /> r- <br /> /i8 <br /> PLUMBING MECHA IC L <br /> NO. TYPE Of FIXTURE FEE NO. TYPE OF EQUIPMENT FEE <br /> WATIR CLOSET ITOLIFTE AIR CONO UNITS-IN P FA <br /> BATHTUB ZpV REFRIGERATION UNITS-HP EA <br /> 12- LAVATORY(WASH BASIN) [XJ DOILIRS-IIP EA <br /> SHOWER L,0 GAS I IRE D A C UNITS-TONNAGE FA <br /> I KITCHEN SINK 6 DISP p I FORCED AIR SYSTEMS-B T U M EA <br /> �.� <br /> DISWASNIR WAIL Hf MFRS-BTU M <br /> LAUNDRY TRAY UNIT HFATFRS-B 1 U M <br /> _ CLOTHES WASHER O FVAPORATIVI COOLERS <br /> WRIER HEATER T CLOIHFS DRYERS <br /> URINAL VENTILATION FAN ' <br /> "C t <br /> DRINKING FOUNTAIN f RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- <br /> CFM <br /> VACUUM BRI AKE RS S TOVF <br /> Roor DRAINS-RAINLEADERS ME EAI FIR[PIACI &CHIMNEY <br /> SINK(SERVICE-BAR,1 TC I <br /> SUB TOTAL (�tJ SUB TOTAL s <br /> "OMIT t PERMIT 5 <br /> TOTAL FEE & (7U TOTAL IF( B <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD$I(BACK PLAN CHICK NUMBER PLAN CHECK FEF <br /> (Of=-:[ ,W c- DIC .3s,- I11 33 RECIIY NO <br /> USE ZONE LOT AREA VACANT SITE <br /> (? /c7 6-m51� ^s ONO FEES VALUATION FEE <br /> TYNST OCCUPANCY GROUP NO Of D)VF IIIHL UNITS <br /> k-3 <br /> SIZE OF BLDG NO Of STORIES MAX OCC LOAD BUILDING t��le-iZO& /1 1 SZ <br /> I PLUMBING /zc I <br /> FIR[ ZONE BASEMENT HE IDR TOMS TIRE SPRINKLERS <br /> �j0 NIQUIRE MECHANICAL <br /> CYFS . O <br /> APPROVALS BY DATE OTHER <br /> N 1 ENVIRONMENTAL CHECK LIST <br /> PENALTY Ii Til <br /> Z BUILDING PLANS SIC fu qd <br /> 7 FIRE HYDRANT TOTAL <br /> R FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> S GRADINGIIXCAVATION 6 CLf ARINGIGRUBRING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 6 DRAINAGE <br /> 7 ENVIRONMENTAL IMPACT STATEMENT <br /> B HEALTH DISTRICT <br /> APPLICATION ACC BY PLANS CHECKED BY APPR FOR ISSUANCE BY <br /> 91-79 <br />