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� � <br />� � <br />N <br />O � � <br />� � � <br />M l+0 <br />�, � <br />� M <br />N <br />N <br />w <br />O M <br />� O � <br />APPLICATION FOR CONSTRUCT�ON PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />I�e E�'B�C/enn <br />CITY OF <br />everett I HEATINGSYS7EM '�GAS OEIECTRIC U � <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMQLITION i COMBINATION BUILD{NG bCMECHANICAL ! PLUMBINQ I SIGN <br />ONMEN MARADD11E55 G��Y 2� � PNOb[ <br />��w,����' ��!?,� J yM'F Pa��_���'ao�- �S� 4a a a� _ <br />? —cz . —0 n ziv P�+E <br />•LL��' /ri`�'" �I� �I � PHONE <br />AR NITEGTORDC6IGNEH MAILAO�RESS UTV ��P <br />GENERI�LCANTR�CtOR M1iL�ODNE55 Giiv !�n PHONE <br />unit <br />cnr <br />UCENSE� <br />ClASS OF WORK ' <br />, I NEW I I ADDITION �Q ALTERATION i REPAIR � DEMOUTION ' WOODSTOVE�FflPL INSERT �.. i BUILDINp RELOCATION <br />coNuc� r�nsn�i �vo riron� wo <br />GONTMCTPRICEOiWORK /� �`� / — <br />noY.MBEW01q(AND60WAEFOOT�OErcryOIVED � <br />u5F OF Ru <br />.�r- <br />LOT BLOLK <br />i - <br />J . I HEfiEBY CERTIFV TNAT I HAVE HEAD AND E%AMINED THIS <br />G(.u/ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL <br />�.owonetuc� �ouat ies� PROVISIONS OF IAWS AND ORDINANCES OOVERNINO THIS TYPE Of <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OH <br />oF NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO OIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVI610NS OF ANY <br />OTHER STATE OR LOCAL UW REGULATINO CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY.WITH THE STATE <br />CONTFACTOr7S LAW 18.27 RCW AND 296200 WAC. <br />5i0N�lUAE� ONAUTMOHqEO ENt O�TE <br />APPLIC/�MTS Cliv PVSMES�ENSE HO µ0 BUSME55 N��l� <br />SUB TOTAL <br />FOR OFFICE USE ONLY: <br />iPONTSETBACR NE�RSETB�CK <br />USEZONE �O�ARE� <br />IYPLOffANI5�l10WMlE ivPFdCOH51.M <br />NO O: S1pRiE5 <br />FIRE <br />REOD <br />FANGEF <br />WqTF�i F <br />METAL <br />FAN <br />� _ .._..._. .. <br />�� "--� SUB TOTAL i , __' <br />.�_ ___ .'___--_PEFtd1T.—_3 <br />' _ _.. __..—._... _"_ <br />TOTAI FEE S <br />SETBACK �'_—rPL�N[Hl:v��!4PiR 1 iFF aELEiC'VO <br />VAC�NI SrtE �CCS^___� <br />BUILDING <br />OCCW�V[. �DwbMtlw4uMrts �_—."'. —'—� <br />4i°J° V�.UMB�NG _ <br />B�SCMENT MECNRNIC�L <br />HkK.HfuMI1�Ti0N � ADDITIONQPIANCHECK <br />07HEN <br />STQE BUILDING SURCHRROE <br />CITY OF EVEHEiT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 9105 roT�� <br />