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r- <br />L. <br />IARfwrpmn APPLICATION FOR kiCITY OF CONSTRUCTIW <br />everett PERMIT <br />DEPT Of COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL IS"745 <br />EVERETT. WA9BID1 COMBINATION ❑ BUILDING ❑MECHANICAL XPLUMBING PERMIT NO. <br />OWNIR MAIL ILIONISS (111 /IP rll(rNl <br />SCO-ir, DANIF L _ 91Z- 43'd 5c �y�P rt �iB20�1 355-�I01S <br />Mf 1111111 IT1U15111NIR MAII AUIIRISS (II) lip NIOW <br />❑NEW ❑ADDITION YAI11RA11ON DR[PAIR :IHMOI.ITION ❑FFNCE ❑SL;N ❑GARACE ❑BUILDING RELOCATION <br />OM l'MII(W OI NORF <br />L <br />IN U NINI %0RM <br />w/ L.Il If S/f'17159' L'+AG'f0d" <br />rxurnen LS}I uI xunuwl <br />IIGAIDIS(KIPHONOIPROPIRIIISHOWNMLOWMAITACHIOUN(OPIISI <br />IOI _AL(.l_()I <br />I HEREBY CERTIFY THAT I HIVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <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 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 RUED AGENT DATE <br />Xaza in 7-a -ea <br />�+ <br />PI I,MBING <br />MECHANICA <br />NO. <br />TYPE OF FIXTURE <br />Fit <br />NO. <br />TYPE Of EQUIPMENT <br />It[ <br />WAIIR( LOSIT IIOLIFII <br />AIR COND UNIIS HV IA <br />RAIHIUB <br />RFf RIGFRAIION UNIIS-HP FA <br />_ <br />LAVATORY (WASH BASIN) <br />ROIHNS-H P FA <br />SHOWFR <br />GAS FIRED AC UNITS -TONNAGE EA <br />NII(IfFN SINK 6 DISP <br />IORCfD AIR SYSTEMS -BTU MFA <br />- <br />DISWAMIIR <br />IS All HIT ATFRS-B I M <br />IAUNDRS INAY <br />I'NII HLATfRS-61U M <br />( 101111S WASHFR <br />I %AN)RAI IVI COOIF RS - <br />WAIIR Mill <br />I IUIINS I IRS <br />URINAL <br />IS'INIIIAII:AN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />f l OOR DRAIN <br />AIR IIANDI ING UNII - C F M <br />VA('UUM INIMURS <br />SIOVI <br />ROOF DRAINS - RAINLI ADFRS <br />MITAI FIRFIlI RCHIMAIFY <br />SINK ISf RVICI -BAR I T( I <br />SUN TOTAL <br />PERMIT <br />TOTAL IEF <br />{ <br />{ <br />SUE TOUT <br />PIRMII { <br />/DIAL FEE { <br />SIDI YARD SI IRM K <br />STREI T S' TOM K <br />RI AR YARD SI I IIAI I. <br />PI AN I MIA NI SHII N <br />TIES <br />PLAN CHECK Fit <br />If[ I RECEIPT NO <br />VALUAI(ON fig <br />USE ZONE <br />LOT ARIA <br />VACANT SITE <br />❑YES ❑NO <br />TYPE OF CONSI <br />(FILL UPANCY CROUP <br />NO Of DWELLING UNITS <br />B1111111N1. <br />S <br />SIZE OF BIT)(: <br />NO OF STORMS <br />MAX OCC LOAD <br />PD)MBING <br />/IRI IUM <br />NASl MFNI <br />NI DNIHIM} <br />FIRE SPRINKLE S <br />REQUIRED <br />(7YfS !!NO <br />MFCHANIC Al <br />APPROVALS <br />RY <br />DATE <br />OTHER <br />1 INVIRONMINIAL CHICK UST <br />Pf NATTY <br />LIBC <br />SIC bR+l <br />7 BUILDING PLANS <br />TOTAL <br />S FIRE HYDRANT <br />A tFIF PROIICTION SYSTEM <br />S GRAVING11 XLAVATION•CLEARING/GRUBBING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IIN THIS SPACII THIS IS YOUR PERMIT <br />6 DRAINAGE <br />7 FNVIRONMFNIAI IMPACT STATLMFNT <br />R HFALTH DISTRICT <br />APPLICAVON ACC BY <br />PLANS LHf CKFD BY <br />APPR TON ISSUANCE BY <br />fRl• <br />91 79 <br />