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m <br />a,,_ ,:,::v. , <br />3 <br />������„ _,.r:�, �«.. . <br />� APPLICATI `t` FOR CONSTRUC7:oNf PERMIT <br />,� TG BE COMPLFTED IN BLACK IN•',-PLEASE PRINT � <br />I.:+ <br />� f }' � BUILD' 3 DEPA^TMENT <br />� '.,, � 25&t t <br />❑ [ AOLITION CJ COM8INATION <br />HEATING SYSTEM: �U�AS ❑ ELECTRIC ❑ <br />C BUILDING <br />i_I PLUMBING I_ i SIGN <br />..J�If77�Z <br />ARCNITECTORUESION'cR M�ILADDRE55 GITV 21P PHONE <br />GEtiEMLCWiH�CTOR MAILADORESS CITY ZIV PHOYE FTATELICENuER <br />�l NEW I] ADDITION <br />LEOAL L_SCPIPfION OF PHOPF <br />LOT BLOCK <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REAPSETBACK <br />USEZONE I �OT <br />� � SR60FBlDG. <br />OCCOPnNGYIOFD <br />f <br />�-` � � flEp50NFOR5PRMKlERS <br />� ' INTAKEBY <br />� <br />AC111AL <br />NO.OF STOR'ES <br />PIANSAPPROVE�BV <br />Citt <br />'�. � REPAIR �._I DEMOLI110N C 1 WOODSTOVE/PRPL INSEFT I l DUILDING RELOCATION <br />�J CANTAGTPERSONANDFHONENO. . _�, <br />$� <br />SIDE SETBACK <br />JACANT SITE <br />CCCUPµCY BO pipW[lllfiG11H�15 <br />cAav <br />� <br />&1SF'AENi <br />HEIGNT LIMITATION <br />CITY OF EVERETT <br />LOCAL SALES <br />TA1( CODE IS 3105 <br />-�/� !9Z <br />i HEREBY CERTIFY THAT I HAVE READ ND E AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TiIS NPE OF <br />WORK WILI BE COMPIETED WITH WHETHER�SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br />AUTHORITY T� VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER 3TATE OR LOCAL LAW REGULA(iNG CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />X rY` ��s'�%L� <br />sax�.une on.c <br />FAN <br />GAS PIPING <br />EXHAUST F/ <br />� I FEE <br />BUILDING <br />PLUMBING <br />MFCHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STqTE BUILDING SURCHARGE <br />PU9LIC WOflKS <br />TOTAL <br />$ <br />FEE <br />FEE <br />