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� r�7 m <br />i0 Xl C <br />7 H V1 <br />��i <br />y �-t <br />O CC O <br />�C M �9 <br />{� M <br />I�tl O � <br />H O <br />O t+ <br />.", � o <br />c� • n <br />M <br />� y <br />t+ H <br />(�] O N <br />c c <br />x�ar <br />H O tl� <br />fhrf:rerb�reen ♦ o,7V�R�V ! ��� <br />(;ITY OF <br />��TPi�� PERMIT PERMITYd. _ �5�bt., <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUhM1BING ❑ SIGN <br />01'.FCR M1IAILPGDRE55 CITY ZIP CIIONE <br />Ll�ertt Housinq AuthoritV 14 d'plar EVesett _ 98201 258-9222 <br />1ENANT IAPILApORE59 GILY Z�P PNONE <br />ARCMITEGTOROESIGNER ��AILA�OPE55 CITY ZIP PMOkE <br />GENEPA�CONTNRCTON h1AiLA00RE5S CItY LP PIIONE LiCC..ti� <br />MECNANICALCONTPALTOR IAA�LFODRG55 CIiT ZIP P��ONE LiCFtSLv <br />C'nrhv Tnr.. 1471 127t1t Place N E Bellewe 98005 646-3471 ('ORRY** <br />�•wiaov+ccoNrn�cror� raannooness arr ziv VMONE r2�2�� <br />c�as5 of vronrc <br />❑ NEW ❑ AOOf fION Q AL?E^ATiON ❑ REPAIH ❑ DEMOIITION ❑ BUILDING HELOCATION <br />LONTPQ PERSON PND PIIONE NO. IF OTMER iMI.N ApOVE <br />CONTRACTPP.ICEOFWORK:S 774� �_ <br />OESCRi�f V OHN AND SOl1ARE FOOTAGE INVOIVED <br />Replace 4 qas Lurnaces � , -" , �.� ,.: _ < < < � <br />! <br />Multi-familv dwellincr _„_ , <br />PROPOSEDU:SOFpWLOV�G ��CN� wE.5.00 <br />— �J! J <br />L[GA� DESCPIPiION OF PROPEPTY �SNOW �EION' ON ATfA�H FOUP COPIES� <br />HECH �55.[;0 <br />LOT �— ��OCK � OF �.. _ <br />HECH �se.00 <br />On file � �;,_; <br />HECH i�5.U0 <br />_ `J_. <br />�oonoaness NECH :5�.00 <br />_ZLZ 13. Z �S rnr�„Gr <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />�ATMTUB <br />_ KITCHEN $INK 6 OISP. <br />� DISHWASMER <br />I'� ' <br />�_ .' LAUNDRV TRAY <br />, CLOTHESWASHER <br />1 URINAL <br />� �� _ ORINKING FOUNTAIN <br />�, ' FLOORDRAIN <br />�� <br />BACNFIOW PFEVENTERS <br />ROOF ORNNS — RAINLEADERS <br />SINK ISERVICE — BAP, ETC.1 <br />� "� s» <br />� �i <br />USE ZONE <br />irr� or mn <br />REASONfOR 5{WINNlEBti <br />APPLICATIONACC 11Y <br />SUBTOTAL <br />PERMIT <br />TO7ALFEE <br />LOTAPEA <br />IVPE OF LONStHI1Lii0N POUII <br />NO OFSTONES <br />FIR[ SPNNNLERSPEOD <br />❑ VES ❑ NO <br />MECHA�!ICAL <br />FEE NO. TYPE OF EO I <br />A/C—A/HNJLGUNITS—H ,:i <br />FORCED AiR SYSTEMS — �.T <br />UNIT HEATERS —� 0 T U. q� <br />CLOTHESDRYERS 1. <br />VENTILATION FAN <br />RANGE HOfJD <br />LYATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN . <br />S � <br />SID[ SffuACH vLAN CHF.CK NUM�ER <br />SUBTOTAL <br />PENMIT <br />TOTAL FEE <br />T <br />� <br />❑ YES O NO <br />«�•„c. i:o ar ow[uacwns BUILDING S <br />PLUMBING <br />pASEMENT <br />❑ VES ❑ NO biECHANICAL <br />HEIGNiLIAIiTATION OTHER <br />STATE BUILDING SURCIIARGE <br />STATEENERGVSURCHARGE <br />CITY OF EVERETT Puouc wor+Ks <br />LOCALSALcS <br />TAX CODE IS TOTAL <br />3105 WHEN PROPERLY VALIDATED <br />PERMITS EXPIRE IF K'ORK IS NOT COMMENCED WITHIN qpDIlESS FILE <br />�Rn nnvs ��� CFASFS FOR MORE THAN 1A0 DAYS. <br />FEE <br />� <br />5 <br />5 <br />flECEIPT NO. <br />FEE <br />2536� <br />65 <br />