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APPLICATII� :� FOR CONSTRUCti .ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />rxl DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ pLUMBING ❑ SIGN <br />PROJECT ADDRESS:i. 907 Lombard �vereLt, WA 98201 <br />Gverett Communi.tv (:olle�e 801 Wetmore Cverett WA 98201 388-9513 <br />OwNEN MAILADDOESS cin zir r!aor�[ – <br />AI�II A11pI1F.55 <br />ARCMITEGTORIlE51GN[0 M�II�DDRESS <br />Owner <br />cer+enu co��m.aon MAII AOUOE55 <br />f.11Y I�P <br />CITY 7�p <br />CIIY----' !il' <br />WRUn� <br />�'���ll��' SGTE IICFNSE � <br />MELH�HIGL CONiRRC10R M�IL ADORE55 CI1Y llP PIIONE STA7E IILENSE � <br />PIIlA1U1NG WIlIfl�C10l1 MAIL �UI]RESS CIIY IIP —_"— PIIOHE <br />STAIE IICENSE � <br />CONfR�Cf PRICE <br />OESGRIBE WORK ANO SOU�RE FOOTAGE INVOLVED <br />o� <br />IEGAl0ESC1i1PilON OF POOPERTY (SHOWN BEIOW IX1 AR�f.11 T WO COPIES) <br />l0T BI.00N OF_ <br />CONSTRUCTIONIO�NlEN0E0.AUUHESS.IElEl410NE NUMBER <br />PLUAABING <br />NO. TVPE OF FIXTUAE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH �ASIN) <br />SIIOWER <br />KITCViEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN � <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />RWIC lCFRVICF _ RAG FTl:1 <br />SUB TOTAL f <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />�RONT SEIDACN RE�II SFTPAGK SIDE SETB�Cfl <br />USE ZONE I OI AIiEA V�f,�fll SIIE <br />I.IYES <br />IIEIGIR UMITATION NO OF UWELLING 512E Of I11U0/f I <br />UH175 <br />O"CUPANGY I,a nr s�omcs I OCCUPANf LOAD <br />Gf1011P <br />FIflE <br />f,01�5T I �IANSAPPIIOVFflOY <br />UPI! <br />FIEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />coNucT rensoe+eNn ruone No <br />Pfarlt Stewart 388-9513 <br />1 fiEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECi ALL <br />PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE OF <br />WORK WILL 8E COMPLIED WITfi WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING Of A PERMIT DOES NO7 PRESUME TO GIVE <br />AUTFIORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIUN OR THE <br />PEFlFURMANCE OF CONSTRUCTION. THAT I AM AUiHORIZED BY THE <br />OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOfl WHICH <br />APPLICATION IS MADE AND I COMPLY WITIi THE STATE <br />CONTRACTORS LAW IB. N 29fi200 WAC. <br />�CGl�� � �� � .� C�M�t- 5/16/97 <br />X <br />SIGN�TUf1E ��7E <br />CI7Y OIISINE55 LICFNSC NO <br />MECHANICAL <br />FEE NO. TYPE OF EQUIPMENT <br />—� A/C—A/HNDLGUNITS <br />� FORCED AIR SYSTEMS - <br />—i— HEAT PUMP <br />� <br />� UNIT IIEATERS <br />i CLOTHES DRYERS <br />�— RANGL' hI00D <br />; WATER hIEATER <br />� WOOD STOVE <br />_�_ <br />� MEfAL FIREPLACE (WOOD BURP <br />� FIREPIACE INSERT QNOOD BUR� <br />GAS PIPING <br />EXIIALIST FAN <br />ri er� r.i mr.K �+uunrn <br />/ � � <br />FEECi <br />�J NU p111101pfi --__ <br />PIIIAlI11NG <br />❑YE} ❑ NO <br />CITY OF EVERETT <br />LOCALSALES <br />TA% CODE IS 3105 <br />MECIUNIC�I <br />♦ppIIIONAI PIANCplCN <br />011l[II <br />SIPIC 11111111111G $IIIILII�OGL <br />PIIIIIIf. V/OIIH': <br />—_...--._._...___.. _.. <br />TOTAL <br />SUB TOTAL S <br />PERMIT f <br />TOTAL FEE S <br />rrr ner.eir� r+o <br />FEE <br />