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,.PPLICATION FO._ Building N9 ���,�„ <br />�� "" CONSTRUCTION 16PunBts e <br />everett PERMIT 2 StorY <br />TO BE COMPLETED IN BLACK INK— PLEASE PR�NT <br />BUILDING OEPT. <br />259•8745 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />pWNER row- estern u�� �R sstng �mite artaters�:ip Z�P PMONE <br />1300 - 114th Ave. S.E., N106, Bellevue, WA 98004 453-9030 <br />MML�ODPE55 ��T�' ZiP PMONE <br />ARGMITECTORDESIONEN #504� HCi�iStn��f TX (713) 789-7530 <br />Starnes, `.�tovall & Daniels, Inc. 6363 Woodway Dr., �iLENSE• <br />Cltt 21P PMONE <br />oENER��cppp�ry;e_�.ctern Construct"W�D1L9f�Pany 453-9030 A lied For <br />1300 - 114th AVe.S.E. 11106 Bellevue WA 98004 pryONE LICENSE• <br />..,........�.� �num�etna M�IL AU�RE55 GITV 21P <br />��n, Z�p PMONE LICENSE • <br />PLUMBINGCONTRACTOA M�IL�DORE55 <br />G �SS OG WORN <br />�'�' NEyy ❑ ADDITION ❑ ALTERATION ❑ REPA�R ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT BUILDING RELOCATION <br />v1 IITION OF WORK �COST OF MATER��$ fLUSIABORI <br />OF <br />�g�r_A a�o�„ 14 oF Interci <br />lot recorded in Vol <br />rds of Snohomish Co <br />2 of NE quarter of <br />R4 Snohomish, Washi <br />1nV - av u���� <br />T�CH FOUR GOPIES; <br />ition, div. nl as <br />120 S.E. Everett Mall Way <br />of plats <br />WA; Parcel B <br />on 24, Tow�sh <br />� <br />I�HEREBY CERTIFY THAT I HAVE REAO AND E�AMINED THIS AP- <br />PLICATION AND KNOYVTHE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIqNSOF LAWSAND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMAIJCE pF CONSTRUCTION. �_(y/ <br />SIGNAT};REOFCONTRACTOHC�AUTHPRI2EDAGENT DATE/� d(G' <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />NEAR SETB�GK SIpE SET6�GK <br />LOT�RE� VACANTSRE <br />❑YES ONO <br />OCCUPRNGYGROUP NO.OFOWELLM <br />IZ- � Ib <br />NOAf S70RIE5 MA%. OLC LO�D <br />;HECI(EUBY IAPPRiORI55UANCEBY <br />J� <br />BUIIA�NG <br />PLUMBING <br />MECl/ANICAL <br />OTMER <br />PENALTY <br />TOTAL <br />FEES <br />FEE I pECCIPT NO� <br />VALU�TION I FEE <br />7 <br />