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APPLICATION FOR CYtfBtthe E <br /> CITY OF "° <br /> CITY �,ONSTRUCTION <br /> OF <br /> everett PERMIT <br /> DEPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259871 <br /> EVERETT.WA98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OWNI �J MAD ADORitt - t•1 CITY ZIP �'C•S,y PHONE <br /> ' /- <br /> ARCHITECT ON DISIGNIA MMI ADDRISS CI - .I PHONE )� <br /> 12nG :r T > 'teo <br /> GSNIRALCONIAACTOA MAIL ADDRl r% Clir ZIP rHOW LICENSE f <br /> �'rie" ��i�e�f�ei�vt� e/&" �./-/So ��Se✓ � vaK,v..00b S'Pb 3 � 7yS- 34•G• / <br /> r 1 <br /> MICNA ICAI CONTRACTOR MAIL ADORE SS OTZIP PO 1 LICENSE II 111 <br /> PLUMBING CONTRACTOR MMT.ADDAI IS CITY ZIP PHONE LICENSEE <br /> CU SOf WORK <br /> NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> VALUATION Of WORK A ^ <br /> DLSCRIRI%OK �J <br /> PROPInIo USE Of RmmING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> S t <br /> P-St Id L_.e E L PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> I «Wl DISCRIPIION Of NOPEAIYISHOWN BELOW OR AT FAIN FOUR(01`1151 PROVISIONS OF LAWS AND ORMNANCES GOVERNING THIS TYPE <br /> _ ,� •A^ .-Er OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> LOT�et««_or OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> T 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 /> SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE)�1 " <br /> Ion AnnM s�Q� ?��' /'�. .2• C X ti.� � q.itwt. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE FEL NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSES(TOLIET) AIR COND UNITS-HP EA <br /> BATHTUB REFRIGERATION UNITS-H P EA <br /> LAVATORY(WASH BASIN) 1101LERS-HP EA <br /> SHOWER GAS FIRED AC UNITS-TONNAGE EA <br /> KITCHEN SINK A DISP _ (7 FORCED AIR SYSTfMe-B T U MEA co <br /> DISWASHIIt OO WALL HEATERS-BTU M <br /> LAUNDRYIRAY UNIT HEATERS-BTU M <br /> CLOTHES WASHER O I VAPORATIVE COOLERS <br /> WATIR MATTER OU CLOTHS DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD 3 <br /> FLOOR DRAIN AIR HANDLING UNIT- C F PI <br /> VACUUM BREAKERS STOVE <br /> ROOT DRAINS-TRAINEE ACE ITS METAL FIREPLACE &CHIMNEY •1j GU <br /> SINK ISI RVIC I-BAR.F TC) <br /> SUB TOTAL p SUI TOTAL <br /> L FIRMIT & ItAMIT f <br /> TOTAL FEE BE TOIAL Fff S O <br /> SIDE YARD SETBACK STREET SETBACK REAR VA SETBACK PIAN CHICK NUMBER Plna IllsK 111 <br /> ( <br /> fit RIL(lPI NO <br /> USE LONE LOT AREA ZrSHE lltf VALUATION Ht <br /> r <br /> iYFS ONO <br /> TYPEF CONST OCCUPANCY GROUP NO OF OWILLING UNITS <br /> N (l_ 3 BUILDING S BD g 0 V <br /> SIZE OF BLOL NO OF STORIES MAX OCC LOAD - <br /> I-1 �` 0 f PLUMBING <br /> TIRE ZONE �F BA [M(NI BIORER)MS FIRE SPRINKIIRS <br /> 3 L ES RIQUIRID MECHANICAL 00 <br /> NIS 'LNo <br /> APPROVALS 11 DATE OTHER <br /> 1 ENVIRONM(NTALCHFCKtIST tint <br /> %I( A54d <br /> 7 RUILOINGPlANS <br /> TOTAL 2, (� <br /> flRl HYDRANT I E <br /> A FIRE PROIIC11ON SYSTEM WfitN TEON <br /> SER N PRROPERLOPERLY VALIDATED(IN THIS SPACE)11115 15 YOUR PERMIT <br /> S GRADINGII R(AVAI ION&Cl I ARINGIGRUBBING <br /> To DRAINAGE <br /> 7 ENVIRONMENTAL IMPACT STATEMENT <br /> B HULTH DISTRICT <br /> APPLICATION ACC BY PUNS CHECKED BY APPR IOR ISS1'AN(I IO <br /> V. c. <br /> 9-1 %9 <br />