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APPLICATION FOR ,- <br />^E°`� C.�NSTRUCTION <br />everett PE RM IT <br />DEPT. OF COMMUNITY OEVELOPMENT SERVICE$ <br />CITY HALL 259-0715 � <br />EVERETT, WA9E201 ��OMlINATION ❑ SUILDING ❑MECFIANICAL ❑PLUMlING PERMIT NO. <br />OWNiII MAII e00MR5 � CITY 21P �NONF <br />� i(. ► P 0 ��P`7 290 3'L Ubw �'R qv E. Lal�l'�Tr 9a2v1 'z5�3 <br />V� (31� �%T L � W �1P�d I � 0'F'�6 ''Rp =�.ili. S. �i . <br />13)- 69�z <br />.27� <br />, PWMPIYCCONTR�tlOR MAII�DDRE55 CItY 1R PNONF UCENSE� <br />[1e53Oi WOIIR <br />❑NEW ❑ADDITION �IALTERAiION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑CARAGE ❑BUILDING RELOCATION <br />VAtUAIIONOf WOIIK <br />� <br />f M � N ' <br />OISCRIPF WOR[ <br />',r f, 7'F'�/e �T I... Qito ✓I,�, b'�+7y <br />PROPOSfL`I:SF OI PUIl01nG <br />. I HERFBY CERTIFY THAT 1 HAVE REAO AND EXAMINED THIS AP- <br />6' G� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />IEG�I OfSCgIP110N Of PIIOY!y r isnuw� uuow o■.nr,cwrou� cornsi PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE <br />S-(j LSS S'rv0 t, �d �'(,C1 -Z ^� � OF WORK WILL AE COMPLIED WITM WHETMER SPEC�FIED MEREIN <br />ioi __eioca_o� _. OR NOT THE GRANTING OF A PE MIT N RES 1 <br />� <br />�IUM�ING <br />NO. <br />DISWASHEN <br />UUNDRY ipAY <br />b+ en+ �TT' <br />Oi il%TURE <br />VACUUM BRFAKERS <br />SL•�A <br />SIDF YAND 5[T! <br />IUSE IONE <br />TYPF OF CONST <br />SIZE OF BIDG <br />flRii ZONF <br />✓C• <br />R, FTC � <br />iU�TOiAI <br />HLLMIi / <br />TOTAtIEE ! <br />STRFFT SCTflACK RUR YARD 5 <br />LOTAREA y���NT51iE <br />O�ES ❑NO <br />OCCUP�NCYCNOUP NO OF DWFt <br />A►MOVAIf <br />+ FNVIFONMENT�ICHECKl15T <br />i 9URDING PUNS <br />J FINF HYDR�NT <br />� FIRE PItOTECTION SYSTFM <br />5 GRADINGIfXGVAlIONBQURING/GIIUBflING <br />6 ORAINAGE <br />� �r�vixar+M�ntn� in+rnct st�t�Mt�+t <br />�Y � D�if <br />R DQES OT P UME O <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW RECULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION, <br />SIGNATU0.E NTR�CTOR ORAUTH041ZED AGENT D�iE <br />a'J�_ �� L7� P� <br />TY►E OF EQUI�MENT <br />AIR CONO UNITS—H.P. EA <br />REFRIGfRAT10N Uf+1T5—MP. FA <br />ROILFIlS—HP EA <br />G�5 FIRED �C. UNITS—�OHNAGE EA <br />WAIL HE�TERS—B.T.0 M <br />UNIT HEATERS—B T U. M <br />VENTILATION FAN <br />fU�TOiAI � <br />R�MIT � <br />TOTAI�[F f <br />NUr.�BER P��N CMECK FEF <br />FEE RECEIPT NO. <br />iE[S VAlU�T10N iF[ <br />NUILOING S <br />PLUMPINC <br />MlCHANIGL <br />OTHER <br />PEN�LTY U.BC. <br />SEC bJl�l <br />TOTAL <br />/E�MIT VAIIDAiION ' <br />WMEN PROPERLY VAl1UATFO IIN TH�S SPA�F) THIS IS YOI1R PE0.MIT <br />