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���PLICATI�-'V �pR CnNSTRUC . ION pERMIT <br />CITY OF EVERETT � BUILDING DIVISION <br />3200 CEDAR STREET • EVERET7, Wq 98201 • 25g.8810 <br />PIROJECT AD qESS: ❑ COMBINATION ❑ BUlLDING ❑ MECHANICAL [J PLUMBING O SIGN <br />� ��17 919 Lombard Bverett_ [aa oR�m <br />388-9;13 <br />— �uor,r — <br />71r <br />(�,� . ......•�' C11Y <br />�WIIL�L� I�P � "'. PIION[ <br />GENEO�L C0— �� MqL AODRE55 —__ <br />GIIY "' lil ___—�_"—____ <br />�'i�ONf SGTEIICFNSE� <br />ucrumir.� ..,...".""_ <br />wr�rRect rnice or wnnH — <br />Of SCRIBE IVOqN ANf] Sp�eRE FOpTAGE IrIVpLyED <br />lQT 91.00N OF <br />3854 180 009 0002 <br />PMCEL TA%ID. NIIMOER <br />CONSiflUC710N lp�N l ENOER. ApORESS. 7EIEPHONE NUMBER <br />PLUYBING <br />��• TYPE OF FI%TURE OR ITEM FEE <br />WATER CLOSEi (TOILET) " <br />BA.THTUB <br />IAVATORY (WASI! BASIN) - <br />SHUWER <br />KITCHEM SINK d DISP <br />DISHWASHER <br />LAUNDRY TRAY ---�— <br />CLOiHES WASHER " ' <br />URINAL �— <br />DRINKING FOUNTAIN � — <br />FLOOR DRAIN <br />BACKFLOW pREVENiEqS <br />SINK fSERVICF — RAn crr � <br />SUB TO7AL f <br />PERMIT S <br />TOTALFEE E <br />FOR OFFICE USE ONLY: <br />fflONTSETflACN REAq5E10ALK <br />SI�E SE70�CN <br />IISE TONE <br />IIEIGIif UMIiAT10N <br />TYPE 06 f,pNSI <br />I O7 MEA <br />NO OF UWELLING <br />UNq 5 <br />V�CANI SIIE <br />nves <br />size or aiucrti <br />nr <br />zi�� <br />. <br />HEA7ING SYSTEM: Q GAS <br />--___.____ ❑ ELECTRIC ❑ <br />CONTACIPCq50NAN1)PIIpNE110 �--�_ <br />I`k�ric Stewart 388-9513 <br />I HEREbY CEflTIFY THAT 1 HAVE FEAD AN ED THIS <br />APPLICATION AND NNOW THE SAME TO BE TRUE ANC �ORRECT qLL <br />PliOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WOqK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OH <br />NOT. THE GRANTING OF A PERMiT DOES NOi PRESUN: TO GIVE <br />AUik10RtTY 70 VIOLqTE OR CANCEL THE PqOy�510N OF ANY <br />O.T4ER SiATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEFlFURRIANCE OF CONSTRUCiII:N. THAT 1 AM AU�HORIZED BY THE <br />OWNER OF THIS PROPEHTY TO PERFORM THE WOHK FOR WHICH <br />APPLICATION IS MAUE AND I COMPIY WITH THE SiATE <br />CONTRACTOqS LAW �g �p�qNqZg620u Wq�. <br />/ -�-� <br />/ � <br />x ��l � � � C�'-'�t' U 5/16/97 <br />SIfN�TURE <br />OAIE '-- <br />C11V BUSWE55lICG1�5C NO <br />OFEOUIPMEN7 —�-- FEE <br />runc;ED AIR SYSTEMS <br />HEATPUMP <br />UIJIi HEATERS <br />CI.OT�IES DRYERS <br />RANGLHOOD <br />WATER HEATER <br />WOOD STOVE <br />MEfAL FIREPLACE (VJ00 <br />FIREPIqCE INSERT (WO( <br />GAS FIREFIACE <br />GASRANGE <br />�IANpICCh111'.1p1'p //J ffF <br />_ (J � <br />_ FEES <br />n No ---- ---- -- <br />nwi nu�r. <br />❑YES ❑ NO <br />I - ���� """' CITY OF EVERETT <br />LOCALSALES <br />—. __ � !'"��. . ___ . _ TAX CODE IS 3105 <br />PIIIAlII1Nli <br />MECIIAl1ICq .._— <br />AD�IIIOlIA1 PI AN f.11(CN <br />U111E11 <br />tiiFll I111�11111!(i SIIIICIIFIIIiI � <br />1'llllll( W�IIIF•{ � � . . <br />TOTA1 � .. _ . �� . . <br />SUB TOTAL S � <br />PERMIT s � <br />TOTAL FEE y � <br />_ <br />nFr.Em� No <br />