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�r �a � <br />C�� <br />�Hycn <br />yxt�-i <br />�H� <br />"�J H �J <br />C/� H <br />h �� <br />H t7 <br />OH <br />HLz70 <br />�V n <br />AH� <br />� <br />rHy <br />gy <br />CG� C7 C� <br />[�7 � Cr�1 <br />zHCn <br />H O p� <br />�,yf':. <br />�PPlI�i'�'TI�N FOR CONSTRUCiION PERMIT <br />: �., r �. ��noon <br />IITOF <br />everett <br />EIUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />7_59 8810 <br />�EMOUTION I I COMBINATION h BUILDING I I MECHANICAL I I PLUMBING <br />�vnen renanoonEss crtv nr p��o�+e <br />'�'r> �%%%ft� �%�nev:.� �IG /`✓-� ���'fe��ii. 9'�0� a/ 9_ 56'3�'77 <br />rananooness cirv zm ruon=_ <br />nnCHitECtOB�E5IGNER MRIl�DOl1E55 GtY 21P PHONE <br />everett <br />� <br />❑ SIGN <br />N <br />�-�. ncnn��� a+���acion� y� reminooness cnr Lr rnoNE ucEr+SE+ � <br />'ri �('.�ase �'lx_r�(,_ZS�n �t.� fC�.�G2�L`� 9B•2o/ 331 �/Df/ t�F1�1/,ed�"-IY,Z/N�C <br />�•r���nML�ICONiMGiOli MNLAOUlIESS CIiV ZIP PHOYE UCENSEI , <br />rlliPDiNGCOHIRAGi00 MNLADDRE55 GITY 21P FHONE LICENSE� ' <br />`'nNEW V�DQ�DDITION l.l ALTERATION I�. i REPAIR I I DEMOLITION f.l WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br />rt1A�1iINFliOVEMENTOAIHiE1U�RREMODELONLY �1 C@�I/TApr PEPSON PHON C <br />��or+inncT Pr.ice oF wonK: 3Ci O DO• A1 U_ _ 7y_h��� �,�..�..� � 33�^ y�l� �� <br />ur^,rninclYORKpHOSqUMEFOOiAGEINYOLVED . � � �� //� � ,� _ , �, �„ � � <br />rr(oroseou=_eoFouaoirvc � <br />irr,n�o[scn iouorrnoaEni <br />IOL��� 9lOCK _ <br />�C!?�� �.__.��Gul� <br />J<C'..c� !-�`%� Q <br />��z,� �,� <br />�� �' <br />t�ROJECi�OURE., <br />PLUMBING <br />y0. TYPE OF <br />WATER CLOSET <br />BATH7UP <br />LAVATORY(W�SI <br />SHOWER <br />KITCHEN SINK 8 <br />SINK <br />rnor+r sEroncK <br />i15E ZGfI�O <br />imF Or conR-I <br />�' l� <br />52E OFOL00- <br />OCCUP�ANLIVLOAD <br />n[�A50 FOnsrn� wK�ens <br />nrrucnnaincc.ar <br />���—��;y---7�L I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />ee�owonnrrncn vauncorn s� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WOFK WILL BE r,OMPLETED WITH WHETHER SF'ECIFIED HEREIN OR <br />oF NOT. THE GRANTIN6 OF A PERMIT DOES N0T PRESUME TO GIVE <br />� AUTHOHITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />�� ��� OTHER STKi E OR LOCAL LAW REGULATING CONSiRUCTION OR THE <br />PERfOR1,1ANCE CF CONSTRUCiION. THAT I �M 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 />���,, f�,�7 ,/ CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />� � SIG1Ui11q[OFGONIRACTOl10RAUTIIOHIZEDAGENT OAtE <br />�`-� � J��'� a��8� <br />�> ��, �� <br />�Pi'IiCRNiS CIiY OUSME55 UGENSE N0. AND BUSINE55 NAME <br />FORGED AIR SYSTEM$—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />WATER <br />WOOD <br />GAS PIPING <br />EXHAUSTFAN <br />$ <br />TOTALf-EE $ <br />nennseiqncK� sioese*�cK r�,� rinr+c�^�kuu�r.�n �� <br />� ` <br />J �� �t' <br />toranen vncnr+rsne FEES <br />� Z� I-I YES i I NO gUIL�ING � `��vo QistmdJ <br />trreoveausr.nemni euvrn�cr irirvmvnux.urirs �^z=� � <br />cnom� PLUMBING <br />.5 <br />NO.oF510AiE5 OnSEM[NI MECHANICAL <br />� I I YES X� NO <br />FlnESPnNHlFOanEoo HflcHrlunlrNloN OTHER <br />I I YES 11:' NO Z S� STAiE BUILDING SUFiCHnRC,E _ <br />STATE ENERGY SURCHAf1GE <br />r�nr�snrry�oycoov CIiY 0F EUERETT PUBLIC WORKS <br />�� �N 5/iy LOCAL SALES <br />TA% COUE IS 3105 TOTAL <br />, . ��_;, , .,�.,st... .._ �.-'� . .. <br />SUB TOTAL <br />N��. <br />QC/' <br />FEE <br />zil:_. . „ , <br />