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APPLICATI��N FOR CONSTRUC'.��.ON PERMIT <br />CITY OF [VERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERET'f, WA 98201 • 259•8010 <br />(] DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: �i %3eZ %�ev�. l ��� _ __ <br />JE <br />/ _/��vr- <br />Tir <br />v c., r �. � � rv� : r +i _ — <br />ARCI ITCGT 011 DESIGNEf1 M�it �D[IOE55 Grv li�' �I�ONE <br />�,/on� <br />GENEiUILONiMG10f1 MeIIA��R[55 OIY IIP n110NE SfAIEUGENSE� <br />dECNANI����ONTR�G70R/ MIJLADDRE55 f.liY ZG' P110NE StAIELICENSE� <br />DESGRIBE WONN �HD SOU�RE i001�GE INVOWED <br />IEGAL PESCRIPTION OF FnOPF <br />l0T BtOCK <br />iucio. <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />LON1�LtPCR50NANDP110NEN0 2���_ �n� <br />��� �� N �, c1�� � I HEREOY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />�' , APPLICATION AND HNOW TNE SAME TO BE TRUE AND COHRECT ALL <br />' PROVISIONS OF LAWS AND ORDINANCES GOVEfiNING THIS TVPE OF <br />�� � WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br />BELOWqiA�T�CNTWOCOPIES) NDT. THE ORANTING OF A PERMIT DOES NOT PflESUME TO GIVE <br />_ o�_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OFi LOCAL LAW REGULATING CONSTRUCTION OR TFIE <br />APPL CR{ OF NHI SPROP S U�� OA P Y EVWORKT ER STATE <br />CnNTR'Af.T D 29 .�200 WAC. <br />CONSTNUC7�ON lnµ �EHDF.R, �DDRE55. TELEP110NE NNABER <br />NO. <br />SINK <br />CIOTHES <br />FIXTURE OR ITEM <br />ojl,�,� / o (RS �y � r/!/%t y�o� .�R�4%ps-� <br />l / , � <br />�p �DOC '�° GI Pw l �CaY� �.� a <br />�u� ��y ��+ <br />FOR OFFICE USE ONLY: <br />iRONTSETB�CK AE�f15ETB�GK <br />USE SOyE.� <br />J <br />HEIGNT LIM', <br />OCCUVANL' <br />GRW <br />FIRE SPRINN <br />NO <br />JQ <br />l0t �I1EA <br />1TICN NO OF DWELIIHG <br />���« <br />NO 0� $�MnIS OCLUPAN� <br />iPREO'D I OFA50N <br />v+ � n,�� '"/1—/`�-7 <br />CITY BJSINESS UCENSC NO <br />dECHANICAL <br />NO. TYPEOFEOUIPMENT <br />A/C — A/HNDLG UNITS <br />FORCEO AIR SYSTEtAS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRVERS <br />RANG'cHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAI. FIREPLACE (WOOD BURNING) <br />FIHEPUICE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />GASRANGE <br />� GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL S <br />PEFMIT S <br />TOTAL FEE S <br />SIOESFiB�Ck IPl�NG2CNNUMflFfi <br />i �.� �� <br />VAGANI S�tE rcw <br />❑YES O NO p1111�Mq <br />SIZE OF BIOGrtI <br />� nwunrvc <br />PASEMENI uFC1lnNif.�l <br />OYES NO/ <br />— �DU�������AI�IANW'(LN <br />on�en <br />zuie owioino sune �unce <br />CITY OP EVERETT runnr.wqnKS <br />LOCALSALES �— <br />TAX CODE IS 3105 70TAL <br />� <br />rEF nEf.FIPT NO <br />VALUATIO�i FEE <br />�V /__i �(� <br />-- — i <br />- — — , <br />--- �jJ 1 %S <br />----��— <br />i <br />� '�� � <br />