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�;�:: <br />� � <br />F <br />�,.�.:,.��,�;:��v. -.,. <br />� .,. <br />.. _ , . ���: ,. . <br />..... . <br />APPLICATI� FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT '— <br />259-8810 <br />❑ DEMOLITION ❑ COM9INATION <br />OWNER �� � Wq.A00RESSA ._L <br />HEATING SYSTEM: U GAS O ELECTRIC ❑ <br />; l BUILDING I I MECHANICAL U PLUMBINCi 17 <br />CITV 21P PNONE <br />MCNIfECTONDESIGNEP MAIIMDRE55 <br />CITV ZIP PHONE <br />��n, =IP PHONE ST�TELICENSE• <br />GENEIULCANTMCR)F MAILA�DHE55 <br />MECHANIC�LCONTP�CTOR MNLAODRESS CITY ZIP PHONE STRELICENSE� <br />_. _.., aunuc STRTEUCENSEI <br />MAIL <br />� . <br />CtASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTEHATION i I REPAIR L 1 DEMOLITION f 1 WOODSTOVFJFRPL INSERT I.i BUILDING RELO <br />CONTRCT PERSON /J!D PMONE N0. <br />IEGAL DESGRir i iun �r rn�rc <br />LOT BLOCK <br />PPOJECT <br />& <br />FOR OFFICE USE ONLY: <br />0 <br />yv <br />� USE 20NE LOT AREA <br />i 7VPEOFGONiS.ALLOWABIE iYPEOFCONSi.AC7UAt <br />� SIZEOFBLOG. NO.OFSTORIES <br />� OCGUPANCYLOAp FIRESPRNKLERSRED'D <br />� REASONFORSPRINKLERS <br />� iurs¢v av PLANS �PPPOVE� BV <br />$ <br />SETBACK <br />r_� <br />ocN�nrvcv xoaIN+[LLmGuxns <br />LflWG <br />BASEMENT <br />CITY OF EVEHETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CARRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES �OVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PENMIT DOES NOT PRESUME TO QIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTf� LAW 1827 RCW AND 296200 WAC. <br />__ IC!/O ��S�cP.6�. �/a'�9 % <br />GAS <br />rJ <br />8 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STFTE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TO7AL <br />M <br />$ <br />a <br />� <br />