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y H <br />� � <br />H <br />C M <br />� H N <br />K � n <br />o m o <br />m � ro <br />y N <br />� y � <br />� � � <br />N � ❑T <br />� H W <br />1-1 H <br />N <br />C N <br />�ro � <br />O N <br />Ir� <br />AiyiPLICATIO�� FOR CONSTRUCTI..i�l PERMIT <br />��,��E��,s������ TO BE COMPLETED IN INK—PLEASE PRINT <br />cirv or <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />,�������p _ MAiIP�DPESS <br />HEATING SYSTEM: ❑ GAS U ELECTRIC <br />BUILDING MECHANICAL PLUMBING SIGN <br />CITY ZIP PNONE <br />, � . _ �,�,- nc^ 7 ._ C .`, Ca�.� _ <br />_....... S.� /,./ E <br />CITV ZIP PHONE <br />nRCHIiECTORDE9GNEN MAILADDRESS <br />CITY 21P PNONE LICENSE• <br />NW1.IBMGGONTRPCTOR M�ILADDRE55 <br />CLASSOFWOFK . - <br />� NEW � ! ADDITION ,\�AITERATION .�_. REPAIF �. - DEMOLITION '. WOODSTOVE/FRPLINSERT �i�_. BUILDINGRELOCATI N <br />CONTRCTPERSONPNDPHONENO. <br />� <br />WOPK <br />ior.j-S ` 5 %> eioc� <br />Of <br />S F/ <br />F011fl COPIES� <br />�%k�� ��['�c, �' �u c��� � 7� � �',=_ <br />Pq0.1EGT ApORE55 <br />i1NK & DISP <br />iER <br />TRAV <br />SUBTOTAL <br />PERMIT <br />FOR OFFICE USE ONLY: <br />FRONTSETBRGK REAR SETB4CK <br />�j � Lo' <br />usezoHe iornnEn � <br />OF LON75 AIlOWRBIE ttFF Of CON51 A[lOAI <br />�� - nl <br />no ni m NO. OF STORIES <br />RE00 <br />N� <br />9� �/to <br />FEE <br />I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />%J ' OTHER STATE OR LOCAL LAW fiEGULATING CONSTFUCTION OR THE <br />— PERFORMANCE OF CONSTRUCTION. TF'AT I AM AU7HORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. �,�� q� <br />SIGNATl1FE0PCONTRRCiORORAUTMORIZEDAGENT �ATE �° <br />X --.] C. (i uC c� i,C�� <br />APPI1CANiS CITV OUSMESS LICEN3E N0. AND OUSINE55 NAME <br />WATER <br />GAS <br />OF <br />AIR SYSTEMS—B.T.U. M <br />�7ERS—B.T.U. M <br />8 <br />SIpE5ET0ACN PLAN CHECI NUMBER iEE <br />5 � �� > >�- � � y�� � ° <br />vncaNi sire ' FEES VALUATI <br />� �UILDING �.��LL� L(.%�-' �+�I <br />acur�rcr xoa�wnuxcuxus - <br />�^aj° PLUMBING <br />•3 <br />ORSEMEr+i MECHANICAL <br />� ADDITIONAL PIf�N CHECK '��' � <br />HEIGHTLIMITAPON � � <br />OTHER ��♦ � [(LtC <br />STATE BUILDING SURCHAPGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX COOEIS 3105 TOTAL <br />5 <br />vy7�c <br />�� <br />9 <br />