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x C "' <br />lTl t7 <br />�C.�H <br />H <br />A H (/� <br />M �•� <br />y �: H <br />�C C] <br />H� <br />O x0 <br />'s] H "�] <br />y yC <br />��� <br />H C7 <br />OH�y <br />H�1 C'�� O <br />y�Y Cq] <br />9 H t�7 <br />t"� H H <br />gN <br />H <br />C7 C7 � <br />��M <br />Z i-3 C/r <br />H O Cn <br />A.PPLIC.4410t, FOR C�N�TRUCTIL a� PERMIT <br />�r�.�..�q.,.�. <br />��,�a� <br />everett <br />I DING DEPARTMENT <br />�������� <br />e <br />BU L TO BE COMPLETED IN INK-�LEASE PRINT <br />259-8810 <br />DEMOLITION C0IABINATION BUILDINfi �MECH<"lICAL PLUMBING SIGN <br />O�YNEfi MAILAD�d'.55 CiIY 21P PHONE <br />RriDr3i� N�r,�v� 2,5� �/�c;,y�i1�J �D �`tlzET; u/� %'�zo3 ��-��� �-�� - <br />tENANt MAIL�DDRESS QTY 21P PMON[ <br />nRCHRECTOFiDE51GNER MRIL�DDRESS CITY 21P PHONE <br />G[NERRLGONTRRGTOR MRRpD�RE55 GIiY ZIP PMONE LICENSEt – <br />lAECMANICRLCONTPOf.TOR MAILAD�RESS Cltt ZIP PNONE LICF.NS`_� <br />r-����`ECC�/snlrc-�l�-��iyCr/� P� 3ox iso�s �v��crjui� �zo� zSZ-3l1� C��GYi2i,� � <br />eiuuHit�GCONTRACTOR MAILRDDRESS LITY 21P PHONE UGENSE� <br />NEW �.�-. ADDITION - . A4TERAiiON .- �. REPAIR <br />1 P�ANt iMPROVEMENT OR INTE�V7C�� �10D[l ONLY <br />CONTRACi P!i C[ OF WORN' '�� ( L% <br />DESCFiBEWyORNANO50U4FEF TAGEINVOLVED <br />'��.-�-G..,-.!G ri.A+ �G�'-�"zC� <br />baovoseo use oF ou iNc <br />LEGRL OESCRiPt10H OF PROPERiV �SHOWN BELO1 <br />LO1 OLOCN OF <br />PROIEGTAODRE55 <br />KITCHEN SINK 8 <br />URiNAL <br />DRINKING <br />ROOF D <br />SINK (SI <br />ATTFGH POVR GOPiES) <br />r <br />FEE <br />DEMOLITION �. �, WOODSTOVE/FRPL IhSERT ,. BUILDING RELOCATION <br />CONL:CT PEPSON RND PHONE NO <br />I HEREBV CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF lAWS AND ORDINANCES GOVERNINC 1HIS TYPE OF <br />WOFK WILL BE COMF�ETF�� WITH WNETHER SPEGFIED NEAEIN OR <br />NOT. THE GRANTING Oi PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO V�nLATE 0.'1 JP.�CEL THE PROVISIONS OF ANY <br />OTHER STATE OF LOCAL ?`.0 ?EvULATING CONSTRUCTION OR THE <br />PERFORMANCF UF COtISTFiUCT10N. THAT I AM AUTHORIZFD BV THE <br />OWNER OF THIS ?ROP =RTY TO PERFORM THE WORK FOR WHICH <br />APP�ICATION IS Mn,u� AND I COMPLY WITH THE STATE <br />CONTRACTORS LAVJ 18.27 RCVr AND 296200 WAC. <br />SIGNATUREOFLONLRnCTJC�RAUiHORiZEpAGENi DAIE j-Yy/�� <br />I <br />x r� - <br />PPPIICRNTSLI P �iN� L�CENSE��OaNDPU5ME55NAME <br />A: C—A/HNDLG UNITS—H.P. � <br />FORCED AIR SVSTEIdS—B,T.U. M E.A. _ _ <br />UNIT HEATERS-6.T.U. M _ _ _ <br />>TION FAN � _T <br />HOOD _ _ � <br />HEAT PUMP <br />GAS PIPING <br />ExHAUSTFAN <br />8 CHIMNEV <br />SUR TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />FRGNTSfTBAGK R[RFSEIORCN SiDES['p4CN PFACH[LKNl11AL5R FEE <br />USEZONE 1.OTAR[A VAGRYTSITE FEES <br />`: YES � I NO eui�oiNG <br />iYPEOiGON51.ALlOWROIE iYPEpfGOHSiACTUAI atur�qo v0o�owlu'�:unns — <br />�onn p�UA'OING <br />SRF.OFBLDu. NO nPSTOAiES ue5[MEei MECHANICAL <br />i ' VES ..' NO <br />OLGUPANCYLOAD FIRCSVRNNLERSNEO'0 N[IGMTIIMITATiON OTHER <br />f'�. YES �� -. N(1 STATEPU!LDINGSURCHARGE <br />a[ASON FOR SPRIIIXLERS <br />STAiE ENEFl(iY SUflCHARGE <br />pi�e���ATILN4CC.BY PUNSPPPRWE��Y CITYOFEVERETT PUBLICWORKS <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />$ <br />PCC[iPT NO. <br />i <br />