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IM Fapnen <br />cirv oF <br />everett <br />BUILDING DEPT <br />259•8745 <br />nes�enea <br />APPL�CATIO�! F'URHARMON & ASSOCIATBS everen <br />CONSTRUCT�ON RPa�Es�taotei 9 � <br />PERMIT Stamvood,WA98292 <br />629-4536 or 771-7153 <br />TO F3E COMPLETED IN BLACK INK— PLEASE PRINT <br />❑ COMBINATION <br />AUIL AOUPE55 <br />�g���. P <br />ra.i� eooness <br />�(Y++���--�� -�i/'/�—�7� G <br />M�iL AO[]HL�� <br />❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />cm na � w�nr�e � <br />PIIONL <br />MECtuNIGL LONTPACiOq MAu �DDNESS Gtt ZIP PIiONE LILENSE • <br />PWM1IBINGCONTPALIOR AIAlLAD0fiE55 CIN ZIP PIIOHE UC[NSE• <br />C1A550L WOeN <br />❑ NEW ❑ AUDITION � AL.TERATION �Q REPAIR ❑ DEMJLITION ❑ NJOODSTOVE/FRPI_.INSERT ❑ BUILDING RELOCA710N <br />VAl W.LON OF VIORN ICOST OF I.IAiERIZLS P W 5 LABOR� <br />WORM <br />����o�,.� <br />Tl'PE OF FI%TUPE <br />_R CLOSET ITOILE7) <br />ITUB <br />�TORYIWASH BHSIN) <br />JJER <br />HEN SINN A DISP. <br />1YASHER <br />l6RV TRAY <br />fHES WASHER <br />�Qp To C�FEI���.�� <br />I HEREBY CERTIFY THAT I HAVE READ AND I:XAMINED THIS AP• <br />PLICATION APJD KNOW THE SAME T08E TRUE AND COfiRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCFSGOVERNING THISTI I'E <br />OF WORK WILL DECOMPI.ET l� I�TH WHETHER SPECIFIED HERE� <br />IN OFi NOT. THE GRANTIIJG O 4ti.M(.ih' Df9EdlSpT(L$1(���v1E TO <br />GIVE AUTHORITY TO VIOLATF OR QjZ{J(: �J� �j VISIQNS OF <br />ANY OTHER STATE OR LOCA� LAW �NG�'j'�TRUCiION <br />OR TH6 P.ERFORMANCE OF CONSI T ! 1 <br />UF <br />NU <br />M <br />or 771-7153 <br />� �V I <br />THIS PnRTION TO BE COMPLETED BY BUILDING DEPl'. PERSONNEL <br />REPRS[Lp4LH SIOESETBACH PLANCII[CKNUTABER i'L�NCIIGCNftC <br />N•A �s�ls �G7 `E`1�1153 AE�E�P,�� . <br />IOiAI�E� VACANTSRE FEES VAW�TION FEE <br />� J/QD sF• �YES �ft�0 - <br />pCC11PIRNf.YGli011P HO.OFDWELLINGUNIiS <br />/��� � BUILDING 528 �%•� �� <br />110 OF SiOPIES 1.14%.00C. LOAO <br />/ ,� PLUMBIN3 � <br />APPLIUiIONACG UY IYL�NSCIItCI(Cll <br />�•f3 � ✓�� <br />IAEGHFNICnL <br />OTHER <br />PENALTY <br />.1PPfi FOR ISSU�NCE �Y <br />L' l . -TOTAL <br />�_ <br />Lb <br />i <br />