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# ""� APPLICATI� FOR CONSTRUC�.�JN PERMIT <br />everett <br />G e <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />.��� <br />'� � <br />��� <br />� �� <br />��Q��'i <br />M <br />Q �� <br />ry� <br />� <br />� <br />�� <br />OW <br />p <br />t <br />C�� <br />Ina E�+rg�uon <br />CITY OF <br />everett HEATING SYSTEM• ❑ GAS O ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />25�,-8810 BUILDING 1 MECHANICAL ^ c ' PLUMBING SIGN <br />/nFuic��ITION COMBINATION <br />�..t,l) i II arrl <br />IAAIL RDORE55 <br />M�I� AOpRESS <br />CILY <br />CRV <br />Z�� <br />ZIP <br />GITY 21P PlIONE LIGENSEa <br />PWMPINGCOMTPACTOR MAtLPODRE55 <br />V NEW �-�� ADDITION .�. ALTERATION .�. REPAIR <br />..,..�.e.�. oorF nr woHK (�4 a5o V! L/ _ <br />awiort+c <br />10T���?_�_ BLOCN <br />ROOF <br />I <br />� <br />�5 NM BELOW O�Rl PTfRCH F U <br />OF tl <br />�-•�� � <br />� �,�8� <br />��h . , <br />FOUNTAIN <br />FOR OFFICE USE ONLY: <br />iBONT5EIBACK RUPSEtOACK <br />USE <br />SIZE OF <br />PEASON <br />1YPE Oi <br />FIfiE <br />r�nNs <br />TOTAL 5 <br />NIT 5 <br />DEMOLI110N ��. . WOODSTOVbFRPL INSEFT ,-��. BWIDING RELOCATION <br />I°�`;;`�%���o'�Ei�.��o11 z�3—qyl� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRE5UME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIUNS OF ANY <br />OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 FCW AND 296200 WAC. ��7 /f� <br />SIGN�iUP OFCONTRAGTORORAUT NI �PGENT �ATE <br />x�� �, �cc�n <br />RPPLICANTS CITV PUSiNE55 UCENSE N0. AND Ol15iNE55 NRME <br />MECHANICAL <br />NO. TVPE OF EOUIPMENT FEE _ <br />BUILDING <br />LZU�r h0IXPM1U6icc,t5 <br />ceav PLUM�ING <br />OaSEIAENT MECHANICAL <br />�.En;Nt uMrtr.nON �DDITIONAI PIAN GHECK <br />OTHER <br />STATE BUILDING SURCH�RGE <br />CITY OF EYERETT PUBLIC 1YORK5 <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />T.U. M E.A. <br />3 <br />TOTAL <br />F[E I p�CEIPTHO <br />a <br />,.....,. <br />, <br />t <br />