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APPLICATI�.�1 FOR CONSTRUCT�JN PERMIT �°e�e'� <br />rnoE�e�g��� TO BE COMPLETED IN INK—PLEASE PRINT � <br />CIiY OF <br />everett HEATING SYSTEM: ❑ GAS ELECTRIC U <br />BUILDING DEPARTMENT <br />259�8[f70 <br />DEMOLITION : . COMBINATION ��ILDING . MECHANICAL ��,-; PLUMBING . � SIGN <br />ONNER MAllA0�PE55 CRV 21P VII@1E <br />t�i�L�cvr� /' r(/rHLl4' �'�'ST �-�^�. �7/tJ G=u;RP..l1LFAI 4.R-/ F�=.t�/i Ye".7a•/ 3S'f'7?I <br />1CNANI M.111A0�flE55 CITY ZIP NONE <br />N/r� <br />ARO�II[CLOflI1E51GNEP M>ILpOD�E55 U1Y TIV GNCNE <br />,•��- -- i ��c 7S �sT S F. C���.ceii � k+�. 9szu 3 3�f.� -�.s �/ <br />GRIE9fL ONiMCiOR AUIL�DOOE55 CIIV ZIG PNWIE LILENSE� <br />���1�--HN.:n r/,'cH��� LX�T.1..C. �I.1/L�F {�LGAGF c•.�<� .��i, 9r.��Y 3� f-»-.� ��cwHocivrnc- <br />IlCLUINILAL CNiRACiOF MAILM1OOPE55 CILY ZiP P1qNE LICENSE� <br />PLOM9IN�O���LTOfl IMIL�OOPE55 CIIV 21P PNONE LICENSEI <br />,: ADDITION '�.7 ALTERATION .-! REPAIR I�.' DEMOLITION !�.I WOODSTOVFIFRPLINSERT .! BWLDMGRELOCATION <br />��� {� .fi <br />CONiPACTPFILEUFWMK ��L'�C�C! <br />�ESC11iBE WOfi6 ANp SW RP[ f Wl\GE INVOLVEO <br />Nr�r i�.:t� sr.:K�G:�«.,:! Fi_'�.-a r <br />rAorosco usE oF euauwc <br />/)✓A�f� <br />ICG�LOEWPIPt NOfGPOPEFIVISNOWN6EtOWOPAIIRCNf01 <br />tOi� 6LCCN OF � <br />rno�¢� nu�FF ss <br />�/. CS <br />FOR OFFICE USE ONLY: <br />fqONiSf10ALM ON.PSEIDACK <br />ZO � / o Fin+�t £'. <br />IISE:ON[ LOiMER <br />/2"Z /.S3Z/ <br />i\GFOICONI51ltONABIk IYCEJiCON5iK1pAL <br />�p� <br />SjJyBL+`F T rvO.OFsiOPi[5 <br />e u tFG Z <br />�CNPANCYl0�0 FlflESPFNhIEFSflEi <br />Al�f N� <br />conuc� vcuwrv..nu.��� r+o. <br />�o I CAe.�Gi_ /I7I �L�� G�-.i <br />I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br />APPLICFTION AND KNOW THE SAIdE TO BE TRUE AND CORRECT ALL <br />PpOVISION50F LAWS AND JRDINANCES GOVEflNING THIS TVPE OF <br />WORK WILL BE COMPLETEU WITH WHETHER SPECIFIEU HEREIN OR <br />NOT. THE GRANTING OF P. PEflMIT DOES NOT P(7ESUME TO GIVE <br />AUTMORITV TO VIOLATE DR CANCEL THE PFOVISIONS OF ANV <br />OTHEfl STATE OR LOCAL L4W REGULATING CONSTRUCTION OR THE <br />PERfORMANCE OF CON57 Hl1CilON. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERiV TO PERFORM THE WOflK FOR WMICM <br />APPLICATION IS IAADE AND I COMPLY WITM THE STATE <br />CONTRACTORS LAW 18 27 F C W AN� 296200 WAC. <br />$I(�NRN FCCNLflALiOPOiiANNOPIZEOAGLNi DRiE �//3�%L <br />X____ ����z cS L�/ Gt�..--i� <br />ppMICANIS CRY BOSIN 'S IICCNSE NO ANO BUSiNE55 NMIE <br />vPGNisiiE F <br />y euaoiec <br />x0 dlMiLLiMGM':i5 <br />np9n 7 PLUMB:NG <br />vuxs�rveoveoev CITY OF EVEHETT <br />'L LOCALSRLES <br />J�7 .�/„/�� TAXCOUE153105 <br />MECHANICAL <br />AOOITIONRL PIAN CHEGK <br />OiHER <br />STFTE BUIl01NG SIIRCMARGE <br />PUOLIC WORNS <br />TOTRL <br />� <br />OG <br />eu <br />� <br />_ 1 �__ <br />I /. i �J� <br />