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■ ■ <br />I � <br />�! <br />r%:;� Ever�recn � C"`APPLICATIOR! F(]�R everctl <br />eVerett C�� ERM TT10�. e <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES � <br />CITY HALL 259-8745 <br />EVERETT, WA98201 ��OMBINATION � BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OIVN[R M�II �DO0.155 ❑11 ��� PIIOM1I ' <br />Mrs. J�se� M. Smith 2413 Harri�on Everett 98201 252-5668 <br />ARCNILLCTORDESIGNFR M�II�DDR65 Uti Z�� �MON[ <br />GENtNM C04TM[TOR M�II ADDRk55 Cliv ]IP PI.ON( UCENSi � <br />Hiver�ide Roof Company 2916 Sute St. Everett 98201 258i:h646 RI-VE-RR-*302T0 <br />M[CMeNIfAICONT0.�ClOR M�ILAOURf55 ❑i1 LP PNOM IICEN5E1 <br />PIU�nBINGCONTR�CIOII AiAll��00.f55 UTY Z�P PMONL IICFNS[I <br />[uSSOf WORR <br />❑NEW ❑ADDITION <br />VMWTION Oi WORR <br />, 5.522.00 <br />OESf41BE WOIIK <br />PROfOSED US[ Of BNIDIr+G <br />❑ALTERATION �REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />' IFCAI DESC�I�t10N pf ApR�T1' ISNOWN EEIOW OR ATT�[N FOUR COPIESI <br />to.�.u«.'.�,��-QQA Dl�[ 2B' 0AC Paikhu <br />! AcCt.I SIS16d-S�3-1 <br />� <br />i <br />�OE ADORESS <br />2413 B�rsi�on� <br />►WM�ING <br />NO. TYrE Oi <br />W�TER CIOSEi ITOLIE <br />6ATHTUB <br />UVATORY (WASH BA! <br />SNOWEII <br />KITCNEN SINK 8 DISP. <br />� DISWASHER <br />LAUNORYTRAY <br />ClO1NE5 W�SHER <br />� W�TER HEATER <br />UAINAI <br />� DRINKINL fOUNT�IN <br />�� FLOOR DRAIN <br />� VACUUM BREAKEqS <br />TYPE <br />tIRF ZONE <br />Ewretc, HA 98201 <br />KRMIT <br />GU] <br />FEE <br />{ <br />{ <br />\IX RUR YAftfl SI.T�ACK <br />VACANT SITE <br />OYES ❑NO <br />GkOUP NO OF DWLLLING UNI <br />IES MA%.00C LOAU <br />I{f.UROOMS IBCSPRINKLIRS <br />AMROVAlS <br />L INVIRONMLN7AL CHECK LIST <br />2. BUIIDING PUNS <br />3. FIRE HYDRANT <br />4 FlRE PROTECTION $YSTLM <br />5 CRAUINCILXU\'A710N R CI.1 ARINGILRUIIHING <br />S OBAINAG! <br />L ENVIFJNMENTAL IMPA[T SiATEM'NT <br />B HFALTH DISTRIfT <br />A'{''lll allilu �e r� u. n................ <br />er <br />I HEREBY CERTIFY THAT I I1AVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORCINANCES GOVEF.�JING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />UR NOT. THE'GRANTING OF A PERMIT DOES NOT PRESUME TO <br />G1VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SICNATURE OFfONTRACTOR ON µITNORIZED AGENT DATE <br />NO. <br />—HP. EA <br />i41i5—MP. E <br />AOIlERS—H B EA <br />GAS f IR! D A.C. �,' iC—dON4AGE EA <br />fORCEDAIRS�ALMi-B1.U. N <br />N'ALL HUTERS—B 1.�1. M <br />UNI7HLATIRS—ASU M <br />LVAPGRATIVC COOI.kRS <br />VfNTILAiION FAN <br />RANLE HOO� <br />AIR HANDIING UNIT— <br />MCUI FlRFPUCf 6 CHIMNEY <br />PUN CM[GK NUMl1lR <br />FFES <br />OUlll)ING <br />PWMOING <br />MLCHANIUL <br />DATE I OTHLR <br />Y[NALT1' <br />FEE <br />OFRMIi { <br />TOT�I iLE f <br />PUN CHEIX FEE <br />FL[ RKEIPT NO. <br />VALU�TiON FFF <br />S <br />U0f <br />SEC. J03(a) <br />iOTAI I I I <br />►ERMIT VALIDATION <br />\vHfN PROPERLY VALIDATCO (IN THIS SPACI ) iH15 IS YOUR PERMIT � <br />