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1 <br /> APPLICATION FOR !Y <br /> Int Ewrpl►Pn • <br /> GiTY OF CoNSTRUCTION <br /> everett PERMIT <br /> OFPT OF COMMUNITY DEVELOPMENT SERVICES <br /> CITY HALL 259-0745 ,F <br /> EVERETT.WA93201 ZCOMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> NIR MALI ADDIIISS n [in 1m PHONE <br /> fl ' lam-. ♦ .ir\ (1...x.11 ��ll -Zl .�.1�) <br /> c K I h T�IFlI�G1IF�>r� �I� IF�L.jr_LF� cttr- y 11P PHONE <br /> ARCHITICTORDISIGNIR M LADPIIISS <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> N�NIC l CONTMCIOR MAIL ADDRESS CITY ZIP PHONE LICINSE I <br /> HLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICE NSI <br /> CLASS Of WORK <br /> NEW ❑ADDITION UALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> VALUATION OF WORK <br /> 14 2 CYXJ on <br /> of FLAILS WORK <br /> PROMM Dust Or BUILDING I HI RE BY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> N„ , ��,,R , y 4PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LEGAL DESCRIPTION I F nonprrD1LY BELOW OR AnAcnTouRconlsl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> PNJET LF�F 1: OR PI) e EtA1 OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> ED )_BLOCK_DF - OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> 18 , <br /> 1 � ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> R OR THE-PERFORMANCE OF CONSTRUCTION. <br /> c SIGy�URE QI CONTRACTOR/01 A7UTHORIZIED AGENT DATE <br /> I'M AnnAlssSI� x <br /> PLUMBING MECHANICAL <br /> FEE <br /> NO. TYPE OF it%TURF <br /> NO. TYPE OF EQUIPMENT <br /> WATER CLOSET(1011111 AIR COND UNUS—H P IA <br /> BATHTUB REFRIGERATION UNUS—HP [A <br /> LAVATORY(WASH BASIN) Q flO1lER5—HP [A <br /> SHOWER GAS FIRED AC UNITS—TONNAGE EA <br /> IORC[D Alp SYSTEMS—B i U MIA <br /> klfCHlN SINK 6 UISP <br /> DISWASHIR Q WAIL HEATERS-1 T U M ?1 <br /> UNIT M[ATFRS—BTU M <br /> LAUNDRY TRAY <br /> 2. EVAPORATIVE COOLERS <br /> CLOTHES WASHER <br /> WATER HEALER B CLOTHES DRYIRS <br /> 1'1 NTILATION FAN <br /> URINAL L9 C) <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C F M <br /> VACUUM BRE AKIRS STOVE <br /> ROOF DRAINS—RAINLI AD[Its METAL FIREPLACE 6 CHIMNEY <br /> SINK ISERVIO.—BAR.ITC) <br /> Ty <br /> _ SUB TOTAL S <br /> SUB tOTAI 1 <br /> ►ILEMIT 1 PERMIT <br /> S TOTAL FEEf IS <br /> TOTALIZE <br /> PIAN CHICK Fit <br /> SIDE Y,AR^D SI TRACK SERIES SETBACK XI AR\AXU SIIO�IA PUNO�M� 111 RECEIPT HO. <br /> W <br /> USE ZONE LOT ARIA VACANT SITE F1tB VAIUAHON Fit <br /> HAFT ONO <br /> IYPt OF CONST OCCUPANCY GRUUP NO OF DWELLING UNITS <br /> l=_" 12—J BUILDING <br /> SIZE OF FROG NO OF STORIES MAX OCC LOAD <br /> 3 � PLUMBING <br /> FIRE ZONE BASEMENT flI ORIX)M$ FIRE SPPRINKHR$REQUI [D MICU+'.�� •1 'n -1 <br /> ..YES II V <br /> APPROVALS BY DATE OTHER <br /> 1 [NVIRONMINIAL CHECK LIST PENALTY UBC <br /> SEC ]RETIRE <br /> Z BUILDING PLANS TOTAL R>S UU <br /> S FIRE HYDRANT <br /> A TIRE PROTECTION SYSTEM WHEN ROPIRlVALIDAt1 VA <br /> 1VNIN PROPS ILII VALIDATED LIN THIS SPACE)THIS IS YOUR PERMIT <br /> S GRADINGIt KCAVAT ION&Ct E ARINGIGAURBING <br /> B DRAINAGE _ <br /> I ENVIRONMENTAL IMPACT SIAIEMINT <br /> B HEALTH DISTRICT <br /> APPLICATION ACC BY PLANS CHECKED BY APPLE FOR ISSUANCI BY <br />