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APPLICATIC`"'� FOR CONSTRUCT'``N P�IRMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS � ELECTRIC ❑ <br />259-8810 � / �� <br />DEMOLITION COMBINATION ✓ BUILDING �MECHANICAL �PLUMBING SIGN <br />pWNE/R \ �) MAILAD�RE55 ( ♦/ GITV [Z�IP(�/� P/HO^N/EG /' <br />CC� h. �✓ �l ��T �R� AD�RE55 �.� C� .� I l 5, S! CITV �A C'� IID �7 Q PM7 Y O' 4 �4i � <br />iENANT <br />MRIL ADDRESS <br />ZIP eHONE <br />GENEFALCONTRRLTOR MAILAODRE55 GTV ZIP PNONE STATELIGENSEa <br />s�� he GGE,J,vac,3�r<� <br />MECMANICAL CONTNACTOR MAIL RDORESS CitY ZIP PHONE STAT! LICENSE � <br />56��.P <br />PIUMBtNGC�TRPCTOR AUIIRDDRE55 I CItV 21P PMONE SiATELICENSE� <br />Se f ze4^ _ �sGr7 �,/es��•rrl� lZJ Sniu( Y.�1-7D �GK975'� ccoi Sr-�zF�iioPc <br />SS OF WOFK <br />NEW �I �DDITION <br />�me�rooircncwnov � <br />PROPOSEDUSE <br />✓ ALTERATION <br />LOT 5 BLOCK �_ OF <br />l�uti�� II:J�'l <br />PRQIECTADDRESS <br />WASHER <br />FOR OFFICE USE ONLY: <br />FPONTSETBr1CK REARSETBACH <br />ll�A � /l A � <br />USE 20NE � <br />lYPEOfLONi� SAt1014ABlE <br />� N <br />SiZE OF OLDG <br />C.>NVGCT �%% S <br />T� �� � 5/Ac� <br />OCCUPANGYLOAO <br />� <br />flEA WN FON SPRINrcLERS <br />INTANE BY <br />� <br />REPAIR DEMOLITION WOODSTOVEIFRPL INSERT BUILDING RELOCATION <br />I LONTRGTPERSONANDPHONENO. <br />\� � i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />/ d v U4 A C8 APPLICATION AND KNOW THE SAME TO BE TRUE ANU CORRECT. ALL <br />nrTncN�ouAcoaies PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />�l 4VORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�° '' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEflFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BY THE <br />OWNEF OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />x �%�. � L,u���� �z / /y � <br />���„��E ,� <br />ITEM <br />SUB TO <br />PERMIT <br />�oTnaEn�/ <br />fYPE 0� NSi A�l <br />.�' i�� <br />N0. OP $TORIE$ <br />� <br />FIRE SPRNNLERS PE <br />��U <br />PLRNS APPPOVEO B' <br />J� �/-,. <br />o[Cur��cr I tio o�mv¢cb,uvns <br />BASEMENT <br />CITY OF EVEflETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />WOOD <br />METAL <br />GAS <br />CMELNNUMO[R <br />�r�-�: <br />DUILDING <br />rwMaiNc <br />MECHA�ICAL <br />ADOI110NAL PLAN CHECK <br />SPRINKLER <br />STATE OUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />8 <br />I[�5�:1� <br />FEE c HECtiri rvo. <br />/� 0' � d �p .�.� / .Tf <br />