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f11I Lraparn <br />CITY OF <br />Af'F'd_lf*-�,^6i'i�i ,'J FOR <br />everett ^� PTIERM T�J�II <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2s9 am <br />EVERETT. WA 98201 <br />EICOMBINATION DBURDING <br />❑MECHANICAL 1_1 <br />PLUMBING <br />PERMIT NO. <br />OWNIR <br />MAIL AUUNiN <br />UI♦ <br />lip <br />NIONI <br />l <br />ARCNIIlC10R Ol YGMR <br />MAIL ADORE IS <br />C1IY <br />ZIPJ <br />PHONE <br />(CITY <br />I. <br />CINIRALCONIRACIOR <br />MAIL ADDRESS <br />Zlr <br />PHONE LICENSE( <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />EIP <br />PHONE LECINSI0 <br />NUMBING CONTRACTOR MAIL ADDRESS C1Tl ZIP PHONE IICINstI <br />CLASS <br />V❑NE`vWORR❑ADDITION [:]ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILI`INCRELOCATION <br />AUAIION Of WORK <br />I � _ - � 7 Lai O[• ez' - <br />DISrRIBE WORK <br />PROPOSED USE Of BUILDING <br />• , <br />LEGAL DESCRIPTION Of PROPIXTYDHOWN BELOW OR ATTACH FOUR COMB <br />LOT �IUMK-OI <br />I - <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TIC <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OI <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />BOB ADORE SS <br />PLUMBING <br />MFCIIANICAL <br />NO. <br />TYPE Or FIXTURE <br />1[F <br />NO. <br />TYPE OF EQUIPMENT <br />FIE <br />WATER CLOSE 10011111 <br />AIR CONTE UNITS -TIP [A <br />BATHTUR <br />Q <br />REFRIGERATION UNITS -TIP F.. <br />IAVAIORY IWASII IIASIN) <br />BOILII IIP LA <br />SHOWER <br />GAS FIRED AC 1, S-IONNAGF[A <br />KITCHEN SINK 6 DISP <br />QQ <br />FORCED AIR S` .MS- 01U MEA <br />- <br />DISWASHIR <br />Q[I <br />WAIT HE AI(RSI TU M <br />LAUNDRYTRAY <br />UNIT 11(MFRS -B T U M <br />CLOTHES WASHIR <br />co I <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />Z <br />DRINKING FOUNTAIN <br />RANGE 11000 <br />11L)OG DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BRSAKIRS <br />STOVE <br />ROOF DRAINS-RAINLIAOERS <br />6{llP'RI HRII'IACF 6 CHIMNEY <br />SINK ISFRVICI -RATE. ITC I <br />SUN TOTAL <br />I SO <br />I 0o <br />SUB TOTAL + <br />PERMIT <br />{ <br />- <br />PERMIT / <br />TOTAL F[I <br />{ <br />Q <br />TOTAL LEI + <br />B <br />SIDI YARD SEE BACK <br />SIFIII SLIBA(K <br />RLAR YARD SLIOALA <br />PLAN CHICK NUMBER <br />PLAN <br />CHECK FEE <br />Q <br />USE ION!' <br />TOT AREA <br />VACANT SITE <br />OYIS ONO <br />_ <br />1[R <br />VALUATION <br />i[1 <br />TYPE Of CONST. <br />OCCUPANCY GROUP <br />Al <br />NO OF DWELLING UNITS <br />RUHDINc <br />f74000 <br />3Cc <br />dD <br />SIZE g1 bID(,� <br />It3� 1/47 S'F <br />C <br />NO Of SIORIES <br />I I V , <br />MAX OC/CC WAD <br />/� <br />PLUMBING <br />' <br />FIRE ZONE <br />BASEMENT <br />I BFDRWMS <br />3 <br />FIRE SPRINKIIRS <br />REQUIRE <br />Erifi rKo <br />MECHANICAL <br />Z <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I ENVIRONMENTAL CHECK LIST <br />PINAIiY <br />u0C <br />SIC SOR,1 <br />2 BUILDING PLANS <br />TOTAL <br />ii <br />_79 S <br />UC <br />S FIRE HYDRANT <br />[ TIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />S CRADINCRXCAVATION 6 CLIARINCIGRUBBING <br />6 DRAINAGE <br />1 ENVIRONMENTAL IMPACT STMIMl NT <br />I HEALTH DISTRICT <br />APPLICATION ACC. BY <br />8>"b <br />PLANS CHECKED BY <br />pw-/) I <br />APPR FOR ISSUANCE BY <br />L ,C, <br />9.1 79 <br />