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APPLICATL ��N FOR CONSTRUC . ION PERMIT <br />CITY OF EVERETT • BUII.DING DIVISION � <br />3200 CEDAR STREET • EVERETi, WA 98201 • 259•8810 <br />p DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:I. 915 Lombard Everett, WA 98201 <br />�vemtt Communitv College 801 [detmor.e EvereL't WA 98201 3II8-9513 <br />OWNEfl M�II.AODf1E5S CIN 1�� PIIONt — <br />IENANT MAII MOfiF55 GIY plP <br />�RCMITEGTOqOBSIGNER MFIIADpqE55 CIfY )II PIIONF <br />Owner <br />GENEMICOIrtMCIOfI MAIIADOfIk55 CIIV !il` IYIOHI� SfAIEIICFNSE� <br />MECII�NICAL CON7R�C70R MAIL �D�f1E55 CITY 111` PIIO��G STATE L�CENSE � <br />PLUM0INGCONTHAf,��R AIAILADORE55 CIIY 21P PIIONE STAiEIICENSE� <br />OESLRIBE WORN ANU 501UHE FOOTAGE INVOlVEO <br />NEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONUC I Pf�50N ANI> 1'110NE NO <br />Marlc Stewarc 388-9513 <br />Vii//7t0 <br />I fiEflEBY CERTIFY Tf1AT I t1�1VE REAO AND EXAMINED THIS <br />APFIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROPOSEnUSEOFB111lDINC PROVISIONS OF LAWS AND ORDINANCES GOVERtJING irilS TYPE OF <br />�'�� . WORK WILL BE COMPLIED WITH WHETHEfl SPECIFIED HEREIN OR <br />IEWLOESLRIPTIONOF�(10PERTY�SHOWNBELOWOqATTALIITWOCOPIES� NOT. THE GRANTING OF A PERMiT DOES NOT PRESUME TO GIVE <br />�or . eiocK _ or AUTHORITY 70 VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER 5I'ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEFlFURMANCE OF CONSTRUCTION. TI1AT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />S93H LAO OOH OOOH APPLICATION IS MADE AND I C�MPLY WITH THE STATE <br />PMCELTA%ID.NIIMBEH CONiRACTORSLAW 1B. N 296.200WAC. <br />CONSTflIIGTIONlO�N1.EN0EB,��ORESS.TEfE1'110NENUMOEII x�L�1/// \ / i .`Ll.�- 5�16��% <br />SIfNAI11PE OAIE <br />PLUYBING <br />NO. TYPE OF FURUHE OR ITEM <br />BATHTUB <br />SHOWER <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FICOR DRAIN <br />BACKFLOW PREVENTERS <br />FEE <br />SUB TOTAL <br />PERMIT $ <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />iRONT SETIIACN REM SFTB�CK SI�E S:lO�CN <br />USE ZONG lOi Af1EA VAC�NI SIIE <br />❑VES ❑ NU <br />MEIGIIf IIMITATION NO OF UwELUNG SIZE Of OIOG�f I <br />IINIIS <br />p�f.UV�HCY <br />GROUP <br />FIIIE <br />RFASON <br />❑YF$ ❑ NO <br />�vrcorr,oi�sr rinnsnrrnovrnur CITYOF[VERETT <br />LOCALSALES <br />i,pii TA% CODE IS �105 <br />CIIY UUSINP.SS I ICCNSC Np <br />Nli�NfllYVLI] VlVlll <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT IIEATERS <br />CLOTfiES DRYERS <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />MEI'AL FIREPLACE (1NOOD <br />FIREPIACG INSERT (WOOD <br />Gl�S FIREPIACE <br />GASRANGE <br />FAN <br />SUB TOTAL E <br />PERMIT E <br />TOTALFEE f <br />PI �N CI IFCN t111N01'O <br />/� <br />pU1101N1i <br />P111A1pIN(i <br />MECIIM�ICeI <br />PDUI I ION�I PI �N f.11l LK <br />OIIIEII <br />SIAIC IIIIII Ii14G 51111(�.II�IIGI <br />1'11I111( 1YOIIFS <br />_.___....... <br />TOTAL <br />fTF � fiFCf:IPi NO <br />