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Pp PLICATION FOR Pe <br /> IN,EY/IVF/an <br /> GDY OF .:ONSTRUCTION <br /> everett PERMIT <br /> D[PT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 2S9474S <br /> EVERETT,WA91201 CICOMBINATION El BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNTA MAlt ADOPT SS Gln III, P'1011 <br /> X A,AI OAo to? 24-0 P•2 St {TJz,,4m-- ut-T T62o3 347-141`3 <br /> ARCHIIICT OR INSIGNIA <br /> MAIL AODILf SS C lY rH0 I <br /> GINHIAL CONIRACTOII MAIL ADDRISS CIIY tlP PHONE IHINf[I <br /> MICHANICAL CONTRACTOR MAR ADDRI SS CIIY IIP NIONI LICENSE/ <br /> ZIP PHONE LIC NSI/ <br /> NUMRINGCONTRACTOR MAIL ADDRESS <br /> CITY <br /> ICLLASS Of WORK <br /> IySSNEW []ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE 081JILDINC RELOCATION <br /> VALUATION Of WORN <br /> 1 <br /> DISCRIM WOR. <br /> r/oroan uH or nunolNc 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS All- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> AnecH faun cornH PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> ucAL INSCRIPTION of"OPTION ISNOWN clow DR <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> LOT_BLOCK—OF OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> j• ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATIIRI OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> EOR ADDRISS ✓ _ y — /��/� �/ <br /> MECHANICAL <br /> PLUMBING FEE <br /> NO. TYPE OF fl%TURF FEE NO. TYPE Of EQUIPMENT <br /> AIR COND UNITS—H P f A <br /> WATER CLOTEI IIDLIF II <br /> RFERIGF RATION UNITS—HP U <br /> BATHTUB <br /> POII[RT—NP FA <br /> IAVAIORY IW ATN BATINI <br /> GAS RRiD AC <br /> UNITS—TONNAGE U <br /> SHOWER <br /> IORCID MR SYSTEMS—BTU MfA <br /> KITCHEN SINK 6 DISP <br /> WAIT Hf ATIRS—BTU M <br /> DISWASHIR <br /> UNIT IIF ALT RS—B7U M <br /> LAUNDRY TRAY <br /> IVAPORATIVf COOLERS <br /> CLOTHES WASHIR CLOUDS DRYERS <br /> WATER HF AIIR <br /> VI NIILAIION FAN <br /> URINAL <br /> RANGE HOOD <br /> DRINKING fOUN1AIN <br /> AIR NANOIING UNIT— C F M <br /> HOOK DRAIN SLOW <br /> VACUUM BREAKERS <br /> METAL (TRIPE ACI 6CNIMNfY <br /> ROOF DRAINS—RAINY AD[ITS <br /> SINK ISl0.VICI <br /> SUB TOTAL B <br /> SUB TOTAL PERMIT B <br /> s <br /> PERMITTOTAL fit B <br /> TOTAL fit L <br /> PLAN CHECK Fit <br /> SIDE YARD SI IRA(K STREET SETBACK REAR YARD SITBACK PLAN CHICK PLUMBER FIE RECEIPT NO <br /> USF ZONE LOT AREA VACANT SITE Fus VALUATION IU <br /> OYES ONO <br /> TYPE Of CONST 5 CUPANCY GROUP NO Of OWEELING UNITS <br /> BUILDING L <br /> SIZE OF BLDG NO OF STORIES MAX OCC LOAD <br /> PLUMBING <br /> jFIRI <br /> BASEMENT BEDROOMS ffiRI SPRRIINKLIRS MICHANICAL <br /> RIQLIIIF151t <br /> AP►BOVAIf BY DAT! OTHER _ <br /> UBC <br /> MENTAL CHECK LIST PINALTY SIC EON.) <br /> PLANS TOTAL <br /> RANTPERMIT VALIDATION <br /> TECTION SYSTEM WHEN PROPERLY VALIDATED LIN THIS SPACE)THIS IS YOUR PERMIT <br /> S GRADING11KCAVATION L CLIARINGIGRUBRING <br /> 6 DRAINAGE <br /> 7 ENVIRONMENTAL IMPACT STATEMENT <br /> B HEALTH DISTRICT <br /> AIPlIGT10N ACC BY PIANS CHFCAlO BY MPR FOR ISSUANCE BY <br /> 91.79 <br />