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f <br /> APPLICATION FOR Ie <br /> Lia"'R LONSTRUCTION <br /> everett PERMIT <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 2598715 <br /> EVERETT.WA982Dt ❑COMBINATION Cl BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNER MAIL ADORE SS CITY LIP PHONI <br /> ©LyYIm/ /foit�!/5 /N� mo 7 S. if3ftc�4l��uP; A(w �dF.ft/rr Yy� 3 s 5 50 3 b <br /> ARcema oR DnICMR <br /> MAIL ADDRESS Clir /an <br /> PHDN! <br /> MALI ADDRESS CITY LR /NOM 1'PINSf I <br /> GINtItAI CONTRACTOR y/// <br /> �S ./'P YJo�f CITY LI/ rHONI LICENSE I <br /> MECHANICAL CONIRACTO MAII ADDRESS <br /> MAIL ADDRISS CIf <br /> Y L I LHON[ IICl NS11 <br /> NUMBING CONIRACIOR <br /> Souz7r Co*^T`; `ANN W09017 W4 <br /> [�hASSOf WORR <br /> a<��EW ❑ADDITION [:]ALTERATION ❑REPAIR ❑ MOLITION ❑FENCE ❑SIGN ❑GARAGE BUILDING RELOCATION <br /> V t Of WORK <br /> A UM <br /> C <br /> otwRIB WORK <br /> norosfDusf of null°iNc I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> A <br /> s `$ f WC:r- PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> LEGAL°1SCRIPTIONOfmOFFRTY(SHOWN51lOWORAl1ACHFOURCOPIES) OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> Sol _�,61ocK��a OR NOT. THE <br /> GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOL LOR"CANCEL THE PROVISIONS OF <br /> A,�� F� ANYOTHE.R ATE QqRd AL LAW REGULATING CONSTRUCTION <br /> OR THE PERF MJCNCE OF CONSTRUCTION. <br /> 4�// SIGNATU AUTHORIZED AGENT DATE <br /> IDR ADDRISS /`. A^ /-_V ,cr�/ •,/ X ✓ / 1-4 J�}I• �' t� <br /> MECHANICAL <br /> PLUMBINGFEE <br /> NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT <br /> WAlE0.CLOSET ITOLIFTI AIRCOND UNITS-HP FA <br /> RI{RICERATION UNITS-NP FA <br /> BATHTUB BOILERS-HI <br /> EA <br /> A LAVATORY(WASH BASIN) <br /> -C� GAS{/RED AC UNITS-TONNAGE EA <br /> SHOWER <br /> FORCED AIR SYSTEMS-BTU M EA <br /> KITCHEN SINK 6 DISP WALL HEATERS-B T U M <br /> OISWASHFR EA - <br /> UNIT HEATERS-81U M <br /> LAUNDRY TRAY <br /> CIO/M[S WASHER EVAPORATIVE CCIOL[RS 27 <br /> I <br /> WATER HEATER CLOT141S DRYERS <br /> VENTILATION FAN--- <br /> URINAL <br /> AN <br /> URIHAI RANGE MOOD <br /> DRINKING FOUNTAIN <br /> AIR.IAN DUNG UNIT- C F M <br /> FLOOR DRAIN <br /> VACUUM BEEF AKINS STOVk ��I <br /> I <br /> DRAINS-RAINLIADE RS METAL FIREPLACE B CHIMNEYSE RYICf-OAR.[TC 1 <br /> SUB TOTAL <br /> 1 <br /> SUB TOTAL PERMIT 1 <br /> "LIMIT i 1 <br /> 1 TOTAL PEI 22 <br /> TOTAL FE[ PLAN CHECK FEE <br /> SIDE YARDSACK STREETS T REAR TA0.°5[TBACK PIAN CHECK NUMBER II 7V RECEI►T NO. <br /> USF ZONE LOT AREA CANT$IZE FEES VALUATION FFE <br /> ES DNO <br /> TYP ONST OCCUPANCY GROUP NO Of D,WFLLING UNI 1) _ [ <br /> +� � 11 BUILDING L ����• <br /> Si Zf O�BLUG NO Of STORIES MAX IXC LOAD <br /> .Z PLUMBING <br /> III <br /> F lRl ?ONE —� BAST AS[Nl URS FIRE SPRINKLERS <br /> _-- <br /> l REQUIRED MICHANICAI <br /> nrls D <br /> APPROVALS IV DATE OTHER <br /> Vlfl <br /> T I NVIRONAIINTAL CHECK LIST PENALTY SII NPeI <br /> L BUILDING PLANS TOTAL -n w <br /> =91tE I/YORANI — <br /> PERMIT VALIDATION <br /> 1 {IRE PROTECTION SYSTEM WAIN rROPIRUPI RLRLY VAIIDAIIo ON IHi' brAt II TINS I5 YOUR PERMIT <br /> 5 GRADING/I XCAVAT ION&CL I ARINGIGRUBRING <br /> 6 DRAINAGE <br /> 7 ENVIRONMENTAL IMPACT STATEMENT <br /> 8 HEAITH DISTRICT <br /> APPLICATION ACC By PLANS CHECK��EIID IY APEMI FUR ISSUANCJOY <br /> VI VY <br /> 4179 <br />