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ar.�,.� <br />cm oF <br />everett <br />259-8745 <br />�' f�`�NSTRUCTION � <br />PERMIT <br />�RMir Nc�: :1919 7 <br />❑ D[MOUTION ❑ COMlINATION ❑ BUILDINO ❑ MECMANICAL '�] PLUMlING ❑ sION <br />py�p M�II ApDRE55 CIiY 21P RIONE <br />Ruth Hammond 3812 Hiqh St. Evarett, WA 98203 <br />�pCMITECT OR DE910NEP M�IL AOORE55 CITY 21P PlqNE <br />OENEMLCONTMCTOR MAILAD011ES5 CITY IIP PIqNE IICENSE� <br />MEGUNIGILCONiR�CTOR MAILADOFE55 CITY LIP RqNE LICENSE� <br />ZANESP*136QL <br />0.111Al�NOCOMTMCTOR M�ILAUDRE55 CITV ZIP PIIOHE LICENSE• <br />2anes Plumbinq 1131 Pine St. Sp.l Everett, WA 98201 259-1985 <br />CW,40F WdIK <br />❑ 1Rw ❑ ADD1710N ❑ ALTEMTION ❑ REPAIR ❑ DEMOLITION ❑ SWlDINOIIEIOCATION <br />y�LWTldI OF NVIIK <br />i <br />pESCRIBE WJ11N <br />Naw water line. <br />Hur sa�nce <br />o aicrnicm ❑ o�s ❑ w000srovE ❑ OTHER <br />Residence <br />LOT � BLOCN � <br />rLUM01NG <br />WATEH CLOSET (TOILI <br />BATMTUB <br />UVATq1V (WASH BA! <br />SMOMIER <br />KITCIIEN SINK 8 DISP. <br />DISHWASHER <br />uunonr rn�r <br />POOF DRAINS — R�INLFlDERS <br />SINI( (�NVICE — &1R. ETC.1 <br />S.H. <br />ITEM <br />NN TOTAL i $ 01 <br />�► s 10 01 <br />iOTA►R[ s I <br />1R SETB�CK SIDE SETBACK <br />f AREA yAGNT SITE <br />❑YES ❑NO <br />LUV�NGYGROUP NOOFpVlELLINGUNITS <br />OFSTORIES MA% OCC LO�D <br />] VES ❑ NO <br />1NSGHECKE�BY APM FORISSWNCEBY <br />1 HEREBY CERTIFY THAT I HAVE READ AND EIfAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITM <br />WHETHER SPECIFIED HEREIN OR NOT. THE ORANTINO OF A <br />PERMIT DOES NOT PRESUME TO OIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTR�CTO/R� pA,UTHqqiR/ED�I1,0�EM�. OP OMMER W"� y <br />X ��mfl /1 l Y i�[37tLJ �� �i`�' / <br />MECMANICAL <br />— AMNDLG UNITS — H.P. <br />iIGEMTION UNITS — H.P. EA. <br />BOIIERS — B.T.U.MP. <br />GAS FIRED A�C. UNITS — B.T.U. <br />FORCED AIR SVSTEMS — B.T.0 <br />WI1LL HEATERS — B,T.U. <br />UNIT HEATENS — BS.U. <br />EVAPORATIVE COOLERS <br />C�OTMESDRVERS <br />VENTILATION FAN <br />RANOEI/OOD <br />WATER HEATER • <br />WOODSTOVE <br />ME7AL FIREPLAI:E 6 CHIMNEY <br />fIREPLACEIN: <br />HEATPUMP <br />6A5 PIPING <br />EXHAUSTFAN <br />BUILDING <br />PLUMBIN6 <br />MECHANICAL <br />ill� TOTAL <br />�EIIIIIT <br />M <br />M <br />i:;].i•Ji . _ , � <br />INVESTIGATION FEE �. �le) <br />STATE BUILDING SURCHARGE <br />STATE E�lERGV SURCHARGE <br />DRIVEWAV PERMIT <br />TOTAL <br />PEIMNT VALIDATION <br />WHEN PROPERLV VALIDATEO (IN THIS SPACE) THIS IS VOUR PERMIT <br />ADDRESS FILE <br />