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EAE E:PErpnEB APPLICATION FOR „ <br />CITY Of CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT. WA9R2D1 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑/LUMBING PERMIT NO. _ <br />OWVIR V M+II +OUMI SS C Y )IP IHOV[ <br />�/ �lGG2cv �- y�i�z 3zy7a <br />ARCHII I CT OR DESIGNIR MAII AOO.... P CITY ZIP PHONE <br />...___�Z[2�`—C/�S�<i�t�G��/�f/"`—I�i/nuo�Sr <br />���U y/S� <br />/� <br />! �/• / <br />PHONE <br />/ IICFNS[R <br />NICMAN I( NIMC1pR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE ICFNS[ P <br />PLUMBING CONTRA( TOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSEE <br />I ASS Of WORK <br />NEW ❑ADDITION [:]ALTERATION ❑REPAIR ❑DEMOLITION ❑FINCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />UE S("RIRI WORK . N'J Z�7 <br />- lo�lfd f r�r� oraovP��.l� � ATE. /rIr / 3 , y , 5) 6 7 'vim <br />PROPOSE6Sf OTof o ;LUDIN, <br />! 5�-!t� <br />I HEREBY CERTIFY THAT I HAVE REA[i AND EXAMINED THIS AP- <br />PLACATION 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. G <br />HORIZED AGENT DATE <br />SIGNATURE Of CONT7z�� <br />X <br />OGAI DI SCRIPTION OI ROPI FLY ISHO%l RI LOW OR ATTACH FOUR COME SI <br />LOT —BLOCK_ OF <br />IOH+ppR14t y <br />PLUMING <br />MEC NICAL <br />NO. <br />TYPE OF FUTURE <br />FEE <br />NO. <br />TYPE Oi EQUI MENT <br />FEE <br />WATER CLOSE OOLItT) <br />AIR C(h+B{uIHS=META <br />BATHTUB <br />RE I RICE RATION UNITS-H P [A <br />UVAIORV(WASH BASINI <br />BOUIRS-HP EA <br />SHOWIR <br />GAS IIREO AC UNIIS-IONNAGE [A <br />KITCHEN SINK A DISP <br />IORCID AIR SYSITMS-BTU MEA <br />DISWASHIR <br />WAIL EHA11RS-BTU M <br />LAUNDRYIRAY <br />UNIT HI AIIRS-BTU M <br />CLOTHES WA91IR <br />IVAPORATM1 ('OOL[RS <br />W'ATIR HIAIIR <br />(IOIHIS DRYIRS <br />URINAL <br />VINTHAIION IAN <br />DRINKING IOUNIAIN <br />RANGE HOOD <br />Fl OOR DRAIN <br />AIR HANDLING UNIT- CTM <br />VACUUM FIRE.AKE ITS <br />STOVE <br />ROOF DRAINS- ELAINE I AD[ ITS <br />MF T AL FIREPLACE PLACE A CHIMNI Y <br />SINK(SERVICE -BAR. I1( I <br />SUE TOTAL <br />SUE TOTAL E <br />PERMIT <br />S <br />PERMIT E <br />I TOIALfH <br />S <br />TOTAL Fit E <br />SIDEV1 OSIIBACK <br />SIRE I1"TBA(K <br />RI AR YARD 5I IBA(1. <br />PIANCHICK UMBER <br />�� _3 3 <br />D <br />PLA.`1 <br />IL r /�(')F <br />7 <br />CHECK FEE / q <br />-RECE1 b <br />USE ZONE <br />LOT AREA <br />VACANT 517E <br />OYES ❑NO <br />/[[S <br />VALUATION <br />F[[ <br />TYPE OF CONS[[79 <br />T..A � <br />H <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING6CD <br />/ <br />! <br />DO <br />BIZ[ OF BLDG <br />---� <br />NO Of STORIES <br />MAX OCC LOAD <br />—"--- <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />. <br />BIDRnOMt <br />IIRI SPRINKLERS <br />RI Q�yJIRID FINDA9 <br />'. S <br />CNANICAE <br />APPROVALS <br />EY <br />DATE <br />OTHER <br />1 ENVIRONMENIAL CHECKLIST <br />PINAITY <br />UBC <br />SEC 701(U <br />2 BUILDING PLANS <br />TOTAL <br />I TIRE HYDRANT <br />A FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHIN PROP[RIV VALIDATED UN THIS SPACH THIS IS YOLK PERMIT <br />S GRADING'EXCAVA7IONAQIARING;GRL. HHIN( <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />E HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />•PPR FOR ISSUANCE BY <br />9179 <br />