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i <br /> IM EYSTBTeen APPLICATION FOR <br /> CItY OF LONSTRUCTION <br /> everett PERMIT <br /> OF PT OF COMMUNITY DEVELOPMENT SERVICES <br /> C I IN HALL 259.874S <br /> EVERITT.WA98201 ❑COMBINATION OBUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> OW NIR MAII ADLIRi SS Tit III Pllllel <br /> I�lef MRS {�DESEZT (,. 3DNNSoL),Q • Elle �9 µ �I SE Fd¢rer/ 4Paa3 35S �sbb <br /> AROITICI OR DISILNIR MAII ADDAI SS CITY ZIP PHONE <br /> �INIRAL CONTRACTOR MAT ADURtSS CITY ZIP PHONE IICINSII <br /> QWlit r <br /> MECHANICAL CONTRACTOR MAIL ADURISS CITY ZIP PHONE LICINSE <br /> MUMAING CONTRAC SJR MAIL AEJ Lily ZIP PHONE LTCINSII <br /> C LASSO)WORK <br /> R41W ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION OUNCE ❑SIGN ❑GARAGE E]BUILDING RELOCATION <br /> VALUATION Of WORK <br /> S 760 <br /> of xI RI WORK <br /> I IlQ4tun of mew woocls4ove_ L heCl r% h E L.UaEI pvoift4or <br /> PROMMD us(al Rwluwo I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> iicp PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LICA)TIES('ji )I PROHRIY(SHOWN BELOW OR ADALH FOUR LOPHSI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> EOT_01(xK_01 OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> 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 <br /> JOB ADDRI SS <br /> ID c It k_ f/ X lLn <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET ITOLIETI AIR GOND UNIIS-11 P FA <br /> BATIITUR RIIRICERAIIONUNITS—HP IA <br /> LAVATORY(WASH BASIN) BOILERS—ETP IA <br /> SHOWER CAS 1111i UNITS—TONNAGE[A <br /> KITCHEN SINK b DISP FORCED AIR SYSTEMS—fl T U M U <br /> DtSWASHIR WAIL HEATERS—BTU M <br /> LAUNDRYJRAV UNIT HIAIFRS—BTU M <br /> CIOTHIS WASHIR IVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> I LOOK DRAIN AIR HANDLING UNIT— C F M <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLf ADT ITS I METAL FIREPLACE b CHIMNEY <br /> SINK(SI RVICE—BAR.ITC) <br /> SUR TOTAL SUIT TOTAL IT <br /> PERMIT S PERMIT S <br /> TOTAL FIT S TOTAL R[ S <br /> SIDE YARD$E TRACK STREET SETBACK REAR YARD SETBACK PLAN CHICK NUMBIR PLAN CHECK FE[ <br /> Fit RECEIPT NO <br /> U51 ZONE LOT ARIA VACANT SITE <br /> OYES ONO IE[f VALUATION F![ <br /> TYPE OF CONST OCCUPANCY GROUP NO Of DWELLING UNITS <br /> F <br /> BUILDING S <br /> $IZE OF 131.0C NO OF STORIES MAX OCC LOAD <br /> PLUMBING <br /> FIRE ZONE BAST MF NI III DRTKIMS FIRE SPRINKLERS <br /> RFQUIRID AEI CHANICAL <br /> .11% NO <br /> AFFIOVALS BY DATE OIHIR <br /> 1 INVIRONMINTALCHICK LIST PfNAl7Y UPC <br /> SIC 31(1 <br /> 2 BUILDING PLANS <br /> FIR[ HYDRANT TOTAL <br /> A FIR[ PROJECTION SYSTIM PERMIT VALIDAIICN <br /> W FEIN PROPERLY VILIDATED IIN THIS SPACEI THIS IS YOUR PERMIT <br /> I S GRAbING)I XL AVAIIONbCIE ARINGIGRUBfl ENG <br /> 6 DRAINAGE <br /> 7 ENVIRONMENTAL IMPACT STATEMENT <br /> 8 HEALTH DISTRICT <br /> APPLICATION ACC BY PLANS CHECKED In APPR FOR ISSUANCE BY <br /> WI-79 <br /> . r <br />