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MA-1'Lr � a�Slc � /o� � . <br />APPLICATION FOR CONSTRUCTION I�ERMIT <br />CITY OF EVERETT � BUILDING DIVISION <br />320U CEOAq STREET • EVERETT, WA 98201 • 259-BB10 <br />❑ DEMOLITION f 1 COMBINATION lit BUILUINO kl MECHANICAL kl PLUMBINQ ❑ SIGN <br />PROJECTADDRESS g��� 1'QSy M�(r ^ f. <br />W � � ��� <br />owrrFn uniinooness � a�r zir m�oNe <br />GP7w.f uams_ T.,� 12�1�, Bt�� Ave. l9 NA-201 � erettLFIA 98209 ],Q6/513-9006 <br />tENANI —�'��-MAIIAbUf1E59 CIIY , Zip p110NE <br />ARCIIITECtOR0ES10NER MnIL�UU11�55 CIIY 21P PIIPNE <br />OENF.�AI,CONiRACIOR MAI�pODtlES9 CIIY ZIP PIIpNE SIAIELICENSE� <br />$gj,�t Hat�c� Tn �1�A71 A h A>P W 8A-70_1 �ra_!-�-;�!� 98204 2t1Ff51�-9(1(16 RF.T.FY`t'T11f1KN <br />MECN�PoCAICIX�iRACtOt1 MAI�AWRE55 CIIv ZIP PIIONE SIAtELICENSF.� <br />PlU!ABINp�pNIPIICiqI MI11��ppRE55 �IIY ZIP P�IONE STAiELICEN51:� <br />bE5Ci11Bp WORK �NU SWAqE FOOTAOE INVO�VEU <br />Construction of one si*Ksle familv res <br />rnovoseo use oF eu�ioir+a <br />Sinq1E familY dwelling <br />LEdAL OESCRIP110N OF PnOPERIY (5116YM BEIOW Ofl ATTACH iW0 COPI <br />�oT Zy a��H � <br />Arinr GlPn. _ <br />PMCEL TA%1.0. NUMBER <br />CONSIIIUCTIONlON7LEN0EA,A0DAE9!1, EIEPNONENUMBER <br />LT H�,,�cd M�r��P -»s- <br />(0�5 2(8 S� SW �9 w � <br />PLUMBINa <br />NO. TYPE OF FI%TURE OR <br />WATEq CLOSET (tOILET) <br />BATHTUB <br />;; IAVATORY (WASH BASIN) <br />SHOWER <br />1. KITCHEN SINK 6 DISP <br />013HWASHER <br />LAUNOflYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKINO FOUNiAIN <br />FLOOR DRAIN <br />6ACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />FOR OFFICE U5E ONLY: <br />FRONtSE7BACk ilEM5E10ACK <br />U9E ZO� <br />� <br />IIEIOHT LIMIIATION <br />� <br />OR�OVPANCY NO.0 <br />FIIIE ALAnM` P1EO D <br />IU � <br />HO.OF OwELUNti <br />urms <br />� <br />SID'c SE7BtiCK <br />�) <br />VAC11Nt StlE <br />❑YES O NO <br />lF BIIXl/CI. <br />,�2 Sf Liv,aG k <br />3o S� GA2a�iE <br />BASEMENt � � <br />❑YE9 W10 <br />I CITY OF EVERETT <br />LOCALSALES <br />5 7AX CODE IS 3105 <br />HEATINQ SYSTEM: I�t! GAS f] ELECTRIC ❑ <br />CONI�CT FE�SON AND PIIONE N0. <br />I HEREOY CERTIFY THAT I HAVE READ AND EXAMINED THI3 <br />APPLICA710N AND KNOW TH[ SAME TO BE THUE AND CORRECT. ALL <br />PROVISIONS OF LAWS ANO ORDINANCES OOVERNINa THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. Tlic ORANiINO OF A PERMI7 DOES NOT PRESUME Tll OIVE <br />AUiHORITV TO VIOLATE OR CANCEL THE PROVISION OI' ANY <br />OTHER STATE OR LOCAI LAW PEQULAT�NO CONSTRUCTION UR THE <br />PERFORMANGE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEp OF THI9 PROPEPTY TO PERFORM THE WORK FOR WHICH <br />APPIICAiION t9 MADE ANO I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br />Select s, Inc�.�f� <br />XBv: � il ldl�� �0/uP��1 <br />siar+ntune OntE <br />CItV BUS�NESS LICENSE NO. <br />NC — NHNDLQ UNITS — H.P. <br />FORCEO AIR SYSiEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIi HEATEHS — B.T.U. M <br />CLOiHES DRYtRB <br />VENilIAiION FAN <br />HANOE HOOD <br />WATER HEA7ER _ <br />WOOD STOVE <br />METAL FIREPLACE IWOOD 6URNINO) <br />OAS RANQE <br />SUB <br />PUN CIIECK NUMOEf� � I FEE I �ECEIPT NO. <br />,i�/�1/n:. lil ' <br />BU�LbINO -7/ay�Q J%��y— <br />=Y1S -�— <br />PLUMBINO <br />MECIIeNICAL � <br />�OOI IIONpL PLM1N CI IECK <br />OIIIEfI <br />S7NE OUIl01N0 SUIiC11Af10E G <br />ruoucwonks _�� — <br />totn� /� � � _ �; i <br />r <br />