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APPLICATIIX 1 �OR CONSTRUCTf ;:: P�Fii111i'P � <br />TO BE COMt'y�ETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYS7EM: �] GAS J ELECTRIC J— � <br />259�8810 . . <br />DEMOLITION ' COMBINATION x BUILDING �'�. MECHANICAL �. . PLUMBING �. SIGN <br />�warn r.uuooness a*r zi� anor+e <br />C��1� ofFaec��} 3iorC�/o� S{, l�ve«it 98zr1/ 2'�9�B�B <br />n,;n�i uuieonness n�v riv vNaue <br />_ Fir� � � <br />ni�onrtr.ronoesicx n r�eiuoonEss cirv zm rr�oue <br />��I11!flntCqiiMCtO� YAILADO�ES$ CIiV ZIP PWNE Si�iEIICENSE• <br />�ici�s oD�Ph �'iy193. <br />IJI_i1fN�LRLC(INiMCitlR 4�I1A00R[55 LIiY ZIV FIqNi $l�Lfl6EN$E• <br />fu2'9�,dGf.ON1FACiOP 4R0.RODflE55 LIIY SIP PXONE SLAEIICENSE• <br />fpNlRnLi VqiCE OF NO <br />%S/')�" <br />uan� newainnoi� or rAwi <br />�o�— o�ocn <br />rnrs�ue. m rvuueen <br />m��snwcrior� �wH iEvoea <br />OF <br />E�G"PO <br />C�OTHES <br />ROOF <br />FOR OFFICE USE ONLY: <br />rr,wusE�uecK nemsemecn <br />uy :.�qc <br />i»_n corsr <br />n%� �/� <br />u:� o=uion <br />n�rnxinv � r�nws=;l�vcoov <br />� � � �� � � %1 : <br />� <br />CONiACi PEX`AN ANU PNqI[ NO <br />I HEREBV CERTIFV THAT I HAVE FEAD AND EXAMINED THIS <br />:PPLICATION AND KNOW THB SAh1E TO 6E TflOE AND COFRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEFNING Tf/1S TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFlEU 4EFFIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUIdE TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PFOVISIONS OF ANV <br />OTHER STATE OFi LOCHL LA1V flEGl1LATING CONSTRUGTION QR THF. <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED F7Y TNE <br />OWNER OF THIS PROPEflTV TO PEPFORM THE WOflK POfl WHICH <br />APPLICATION IS MADE ANO I COA7PLY WITH THE SThIE <br />CONTRACTORS LAW 1827 RGW AND 296.209 WAC. <br />�i VES �i NO pUILOING <br />oa�r.r,cr ..odw*uiwunns <br />�°'1P PIUM�ING <br />945EMENi MECHANIGRL <br />:': VES '-'. NO -- <br />HewNiuwinnq+ AODITIONALPLANGNECN <br />OTHEfl <br />SiN[ BU'L�ING SURCHARGE <br />CITY OF EVEHETT rueucwonrcs <br />LOCALSALFS <br />TAX COOE IS 3105 TOTAL <br />rt[ <br />M <br />