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APPLICATION FOR <br /> everett <br /> CONSTRUCTION . <br /> = <br /> DEPT. OF COMMUNITY DEVELOPMENT SERVICE.S PERMIT <br /> CITY HAIL 75M745 <br /> EVERETT,WA 98701 E)COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br /> ON MIL ADORI5S <br /> �1-.� PIIONI <br /> VS�2YEr Q0X ri$I tYc21 U�7 . 88020 `1l lo-LbQ�L _ <br /> ARC HCIOR 1 ICER nAII ADDRI t CITY ZIP PHONE <br /> M d_j i� 2 L 8a -01 <br /> - G[NI RAI LINER FOR eu ADI 55 CITY ZIP PHONE LHEN51I <br /> , p, 716 <br /> ' <br /> MICHANICAf CONIRAC R MAIL AODKESSCITY [IP <br /> PHONE LICENSE 1 <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br /> CLASS OF WORK <br /> NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION KFENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br /> VALUATION OFWORKWORK <br /> S 'JV <br /> Of CR1111 NOR <br /> Irl Odra atl*:4 4r kw-?A (nca <br /> r•RUNn1Du of RunnlNr. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LIC•AI DISCRIP7 ON Oi PROPIRTY 1S"O%,I m,5 OR AIIM H FOUR COPHO PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> On &_fROCK_CHOF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> -T� 2 OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> '- A ( GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> TT- ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> Z S -4- SIC A URE OF CONTRACTOR OR AUTHORIZ[D AGENT DATE <br /> FOR AIIDRI 51 �W/1 1 <br /> J)LA <br /> /56nd- L,-/w uJ XAt ht <br /> PLUMBING MECH ICAL <br /> NO. TYPE OF FIXTURE 7 FEE NO. TYPE OF EQUIPMENT Ft[ <br /> WATfR CLOSET(TOLI[T) 0 AIR COND UNITS-H.P.EA <br /> BATHTUB REFRIGERATION UNITS-H P.[A <br /> LAVATORY(WAS"BASIN) ROILERS-H P. EA <br /> SHOWER GAS FIRED A C.UNITS-TONNAGE U <br /> KITCHEN SINK 6 DISP Q(� FORCED AIR SYSTEMS-R T U. MEA <br /> DISWASHER WALL HEATERS-0 I M <br /> LAUNDRYTRAY 15UNIT HFATIRS-RTU X51 my d <br /> CLOTHES WASHER IVAPORATIVE COOLERS <br /> WATER HEATER I OTH[S ORY[RS <br /> URINAL Q %IN7ILATION FAN <br /> DRINKING FOUNTAIN <br /> HANG[ MOOD <br /> Q EIOOR DRAIN U AIR HANDLING UNIT5oft_F M (� <br /> VACUUM BREAKERS STOW <br /> ROOF DRAINS-RAINLFADI ITS Lp METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE-RA.R,ETC I <br /> SUR TOTAL �j OC7 SUB TOTAL { �U <br /> PERMIT S PERMIT { <br /> TOTAL FEE { (f0 TOTAL FEE { �) <br /> SIDE VAAR.D{A:STTBACK STREET SE TRACK BEAR YARDI{YS}T-RACK PLANCHICK NUMBER PLAN CHECK HE <br /> I^ . `. 02 ft. 40.E ri 1 .1 o/ofit R[C IPT NO <br /> USE ZONE LOT All A \' CANE 517E / ei08' cS 37 <br /> -A `104 kreq YES ONO FITS VALUATION FEF <br /> iVPI OF CC NSI OCCUPANCY GLtOUP NO Of�-II.ING UNITS <br /> or <br /> I N pO OF O IE LyILf MAXBUILDING Sr.�.+� 9037 CO <br /> SITE Of BLDG NO OF STORIES % (LCC TOAD <br /> NN11�crC , N'A`( NT BI I7R(1051t IIR�Sc,*4. S PLUMBING �'^ <br /> 0,3 IIW/1 N VUBID MI L'l1ANICAI �A�R./ <br /> ��1"`��ffN//111���//� '1 S 11N0 <br /> APPROVALS BY DATE 07HFR <br /> 1 INVIRONMINIAL CHECK LIST <br /> PE NAI 71 URIC <br /> 7 BUILDING PLANS SIC 701(1) <br /> 1 FIRE HYDRANT TOTAL <br /> 1 fill[ PRIIII(TION SISTINE PI RMIT VALIDATION / d <br /> SC.NAUIW.111 A\'A7IUNA UTARINGr•NI'HIIINI, � � <br /> I'RI n9 R I Y 5 51 IDA'TI D JI% 11115 51'Ml l 11115 1\Y nl'X 1'I NAll l <br /> h DRAINA(J <br /> 7 1 NVIRONMINTAI IMPACT STATEMENT <br /> B tit APPLICATION <br /> DISTRICT <br /> APPLIC <br /> ATION ACC BY PLANS CHECKED 01 AI`PN EOR UM +•. I In <br /> N W,4i <br /> H, -q <br />