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r: <br />0 <br />fh� EverprNn <br />CITY OF <br />everett <br />9UILDING DEPARTMENT <br />?59-8810 <br />•�. ,�,� <br />r.PPLICATION FOh ` <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />everetl <br />e <br />C DEMOLITION O COME3INATION 1S�BIJILDING ❑ MECHANICAL G PLUMBING ❑ SIGN <br />�OWNER MAILAOOR[55 Cltt ZIP PMONE <br />//"��/li�eiF_ !,l ES7 �-In,uG� ¢%�9 r/Isr�t. Sc�J ,��u��i�TC��7 /�5a-77.� a.�5-iSq� <br />AHCIUTECI UR �f5i4NEN MNI� Appq[SS Cltt 21P PNON�. <br />Zllf1 }�N �tJ/.ti �3F�T i �9Q/ .� _�AN//cn, s' �-J. L S�n9NcOoc� <br />� GENERA�GONiPAQOR MnILa��AE55 C�rv 21V n1�ON[ �.ILEtiSE• <br />� r% J �� � �'' ��� �(i-�-'�tJCI 4 / <br />n1LC1�AN�CaI CON ACTOq h1A1L AODAE55 G1Y Z�P PIIONE LICEvSE • <br />PWL�BIN�CONLRACIOF ��A�1.ADOPE55 bLY /IF p110NF IICENSF � <br />C�A55 OF LYORY <br />,� NEW ❑ ADDITION ❑ ALTEFATION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPL.INSERT ❑ BUILDING RELOCATION <br />/ V�4TiONOf WORF�CA51 <br />X� �l� �(J <br />� DCSCR16E W RK ` <br />L'D�l�$'T,e.�cC7�C <br />1 USE Of BL'LL�ING <br />cil NQ-LE /I i <br />LLGwL �ESCFIP1iON OF cR( <br />�' ��� 3 a�o��� <br />PROJELTAODRE55 <br />3 ��o �. - <br />LP�VMI <br />� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />'✓ 1�LU.GL/N — y PLICATIONANDKNOWTHESAMETOBE"tUEANDCORqECT.ALI <br />rrisnowane�owoaniracMvouacowes� PROVISIONSOFLAWSANDORDINANCE..GOVERNINGTHISTYPE <br />13R/flAL �H l� OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE <br />IN OR NOT. THE GRANTING OF A PERMITDOES NOi PRESUME Tp <br />GIVE AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. y/ <br />SIGNATURE OF �ONTRaCTGR OR FUiHORIZE� AGENi DaTE �'u'�"�V <br />G <br />PLUMBING <br />NO. TYPE OF FI7fTURE OR ITEM <br />WATEF CLOSET�TOILET) <br />BATH"UB <br />LAVATI�RY (WASH BASIN{ <br />SMOWER <br />KITCHEN SINK d DISP <br />DISFIwASHER <br />LAUNDRYTRAV <br />CLOTHE$ WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FOOF ORAINS — PAINLEADERS <br />SINK �SERVICE — BAF, ETCJ <br />�AOHrSE��arK <br />ZS � <br />115E LONE <br />�� � <br />fYP[ OF CONSL <br />�-N <br />SUBTOTAL <br />VERMIT <br />TOTAI FEE <br />REARSEIBPCN / <br />zS <br />LOTAREA <br />OCCUPANCVGHOU <br />R-3 <br />NO Of SiORtES <br />I <br />2ED ❑ YES OI <br />�'�ANS LNECKED B <br />� <br />PI�LICAN SCIiY0U51N bLClNSENO <br />�D1 D-� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT _ <br />A/C — A/HNDLG UNITS — H.P. <br />FEFRIGER.4TIONUNITS—HP EA. <br />� BOILERS—BSL.iH.P. <br />C GAS FIRED A.C. UNITS — B T.U. <br />� FOPCE� AIR SYSTEMS — B.T.U. M EA. <br />C WALLMEATERS—B.T.U. M <br />UNITHEATEPS—B.T.U. M <br />� EVAPOR4TIVECOOLERS <br />CLOTHESDRYERS _ <br />VENTILATION FAN <br />FANGEHOOD <br />WATER HEA7ER <br />wOODS70VE <br />METAL FIFEPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SIDE SETBAGK � <br />%'z <br />VACFtlT SRE <br />xvES '.]N'J <br />NO OF DWELIiYG bNitS <br />/ <br />Mn% OCG IOnD <br />Ni? <br />AVPR FOR ISSUANGE BY <br />/v.C/ <br />7LnN CH(CCN NUMBER <br />83�1q7�� <br />FEES <br />BUILD�NG <br />PIUMBING <br />MECHANICAL <br />OTHER <br />$TATE BUILDING <br />FEE <br />SUBTOTAL S L <br />PERMIT S <br />TOTALFEE f � <br />FEE �D F7ECEIPT NO. <br />�/�� G ��I <br />S7hTEENERGYSUFCHARGE <br />PUBI.IC WORKS <br />TOTAL <br />VALUATION <br />5 IIC ,._. <br />� <br />pF :PERTYOWNEPSARERESPONSIBLEFORDETERMININGALL <br />P' JPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />