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FM EYPfgmn APPLICATION FOR <br /> CITY OF IN.I,ONSTRUCTION e <br /> everett PERMIT <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CI1Y HALL 259-974S <br /> E%ERETT,WA 98201 ❑COMBINATION i..l BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNER MALI A[1pM15S CITY ZIP PHOCN'JI()�1�Y�I <br /> LESLIE ` C,C/F/= �- 7G'=` 3� S . (J T ��A. /?eaV` 3.5577/`/ <br /> ARCH I II C I OR UI S ICNI It MAIC.ADONIS% CITY IIP PHONI <br /> GI NI1R?�(ONINAC EOR ' / MAIL AppRI SS CITY ZIP PMOMI TILE MSI 1 <br /> /�/crFF 9 _D fro +>/ X07 �i �vc�E7T t�A. 3 3SS/711 <br /> MICHANICAI CONTRACTOR MMI ADONIS$ CITY ZIP PHONE IICINSE I <br /> PIVMFl CONTRACTOR MAIL ADORE$$ CITY ZIP PHONE LICINSE <br /> CI ASS Of WORK <br /> ❑NEW ❑ADDITION OALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> VAIVANON Of WORK <br /> 1 3o(, n <br /> OISCRIRI WORK <br /> �orti� 3 bLouc Fv.YN �AT/Ong <br /> PROPOSED SI Of BUILDING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br /> p PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT ALL <br /> IICI DISCRIPHONOF PROPHNIY(SHOWN RIIOW ON ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> LOT_RLOCK_OF OR NOT THE GRANTING OF A PFRMIf DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> 393S-- 000 - oo t - oioa ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> Y O^ THE PERFORMANCE OF CONSTRUCTION. <br /> SII,TNAIURE OF CONTRACTOR OR AUTTH---��SOR//IZZfD AGENT DAT[ <br /> I. PLUMBING MECHANICAL <br /> NO. TYPE Of FIXTURE FEE NO. TYPE OF EQUIPMENT FEF <br /> WATER(LOSE 1 I lOLIETI AIR CONES UNITS-HP [A <br /> BATHTUB REIRIOFRAIIONUNITS-HP [A <br /> LAVATORY(WASH BASIN) BOILERS-HP [A <br /> SHOWIR AS FIRED AC UNITS-TONNAG[ [A <br /> KIICHfN SINK b DISP FORCED AIR SYSTIMS-B I U AREA <br /> DISWASHIR WALL HEATERS-BTU M <br /> i IAUNDRYTRAY UNIT HEATERS-BTU M <br /> 1 CIOTHIS WASHER IVAPORATIVI COOLIES <br /> WAIIu HIATIR CLOTHES DRYIRS <br /> URINAL VENTILAIION IAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- C F M <br /> VACUUM BRI AKI RS STOVE _ <br /> ROOF DRAINS-RAIINLIADERS METAL FIRIPIACI IS CHIMNEY <br /> SINK ISI RVICI-OAR.IIC 1 <br /> 14 SUN TOTAL SUB TOTAL F <br /> /1 PERMIT B PERMIT S <br /> TOTAL F!! / TOTAL 1EE 1 <br /> SIDE IARDS[TBACK SIR111 SETBACK REAR YARD SITBAIK PIAN CHICK NUMBIR PIAN CHECK FEE <br /> FL[ RECEIPT NO <br /> USE ZONI LOT ARI A VACANT IT[ <br /> GYES })110 1![S VALUATION i![ <br /> TYPE Of CONST OCLUPAN YLROUP NO UI DWEIIWG UNITS <br /> C <br /> /° LC 7A4 T1 IT BUILDING S <br /> SIZE OLUG NO OF STORIES MAX (AC ILIAD <br /> Y10 Sit F7-• PLUMBING <br /> FIRE ZONI BKSf MEN) HI DROONSS )IRF SPPINKLIRS <br /> I REQUIRED MI IIANKAI <br /> nvfs LINO <br /> APPROVALS BY DAT[ OTHER <br /> 1 ENVIRONMENTAL CHECK LIST UB( <br /> PINALII SIC IORR) <br /> Z BUILDING PLANS <br /> I FIRE HYDI I TOTAL <br /> R FIRE PROTFCTIONSYSUM. PERMIT VALIDATION <br /> WHIN PROPIRLI VAI IOATEO HN THIS SPACTI IRIS IS YOUR PERMIT <br /> S GAADING11 NC AVAilON6CLI RINGILRUflflING <br /> N ONAP.A(A <br />