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E.,p;m -APPLICATION FOR <br />- � CONSTRUCTION <br />CITY OF <br />everettPERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OW41R MAIL AOOa155 <br />C r llP PHONE[ <br />51W � � �977_ 32971b75 <br />OR <br />MAIL <br />y—/02 6 <br />PI I R .CO TRACTOR MAIL ADDRISS CITr ZIP PHONE LICENSE# <br />SINEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />Y AILIAT ION OF WORK <br />f <br />DISLRIeI WORK <br />PROPOSE vsl or HunCD14. <br />I HEREBY CERTIFY THAT I HAVE REA AND EXAMINED TH15 <br />AP-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 AUTHORIZED AGENT DATE 06 <br />l <br />t! OISC1 ION or Roalan lSHOWN BD OW OR ATTACH I OUR COP Hs) <br />LOT BLOCK _OF <br />►LUMtING <br />MITI: NICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO, <br />TYPE OF EQUI MENT <br />FEE <br />WATT R(IOSI 1 I101 FETE <br />AIR CONED-4:0NHS—M9 A <br />HAIHTUB <br />REFRIGERATION UNITS —HP [A <br />LAVATORY 'A ASH HASINI <br />BOILI RS—H P EA <br />SHOWIR <br />GASFIR[DAC UNITS —TONNAGE EA <br />KITCHEN SINK R UISP <br />FORCI O AIR SYSTEMS—B T U MIA <br />DISWASHIR <br />WAIT Hf AI[RS—DTU M <br />LAUNDRY TRAY <br />UNIT HE AT[RS—FETU M <br />CLOTHIS WASIIIR <br />IA'APORATIVE COOLERS <br />WATER HEATER <br />(IOTHIS DRrIRS <br />URINAL <br />VENTILATION MN <br />DRINKING FOUNTAIN <br />RANGF MOOD <br />FLOOR DRAI4 <br />AIR HANDLING UNIT— C F M <br />VACUUM FIREARMS <br />SIUYI <br />ROOT DRAWS—RAINHADIRS <br />MI lAl I IRIPLACI 6 CHIMNFr <br />SINK ISE RVICE — BAR. f 1C 1 <br />SUN TOTAL <br />SUE TOTAL 1 <br />PERMIT <br />/ <br />PERMIT IF <br />TOTAL ELF <br />f <br />TOIAI Fit f <br />SIDE YARD SETBACK <br />STREET SI TRACK <br />REAR YARDSITRACK <br />PIANCHECK UMNIR <br />�s <br />3 <br />PLCH[CK <br />1I a <br />�> <br />It[ <br />-VIC[I TTNO /'' <br />`> b y , S6 <br />USE ZONE <br />LOT AREA <br />VACANT SITEd <br />DYES ❑NO <br />FEES <br />VALUATION <br />Fit <br />TYPf OF CONST. uT <br />�T I FEZ Tit2 h <br />OCCUPANCY GROUP <br />NO Of DWILLINL UNITS <br />i r <br />BVUUIVG <br />f <br />�' <br />ao <br />SIZE OF BLDG <br />NO Of STOR IF <br />A <br />MAX OCC LOAD <br />--- <br />PLUMBING <br />FIRE ZONE <br />HASEM[N7 <br />HE DROOMS <br />FIR[ SPRINKLERS <br />REc IRED <br />'r4O <br />kil CHANICAI <br />APPROVALS <br />BY <br />DATE <br />OT'if R <br />1 ENVIRONMENTAL CLUCK IIST <br />1'I%AI 11 <br />111C <br />Sit rtn.l <br />7 BUILDING PLANS <br />J FIRE HYDRANT <br />TOTAL <br />A TIRE PROTEC71ON SYSTIM <br />PERMIT VALIDATION <br />WHIN PROPERLY VALIDATED(IN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADING KCA\'ATION6Cll ARING'LRUHflING <br />1. DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />N HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHICXED BY <br />APPLE FOR ISSUANCE Br <br />91-79 <br />