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� tii�;. <br />j`' � APPLI�TION FOR CONi�T �1� CTION <br />� PERMIT <br />" M�Ewrpnrn everett <br />I CITVOF <br />� everett e <br />� BUILDING DEPARTMENT <br />� 269-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />� NE� MM��DDPE55 GTY ZIP PNONE <br />7��'J.'�O f�/l9� /%2� ,�1/�.9n/O A1/�' �Uf' 9�Za3 353 -�su� <br />� ��T � MAIL�DD E55 CITY 21P PMONE � <br />! <br />I �p�NREGTOR0E810NER MML�DORESS CITY 21P FMONE <br />, OENEM�CONTq/�Cfpp MML�DDRE55 pTY 21P PHONE UCEN9E• <br />, MECNANI�C�O MAILAUORE55 CITv 21P F�ONE L�CEHBE• <br />� RUM&NOGONTMCTOP MAIL�ODRE55 CRY 21P PNONE I�CEN9E• <br />t ' <br />� � <br />i <br />r <br />'.j <br />lOFNONK <br />NEW ❑ ADDITION ❑ ALTEMTION ❑ REPAIP ❑ DEMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ BUIlDINO HELOCRTION <br />II(!II NlMVYCL VIYLT <br />(iO�a�'s — <br />��or e�ocK o� <br />PWM�INO <br />ii:7til <br />� <br />� <br />i �. 2e. <br />� 116Ej� E LOTME� <br />K— � �� 6�� <br />7YPEpFCON9T. OCGUPANCYOROUP <br />� KU.NMLEMGiU�I I I 17'� <br />\/. !Y �� <br />j MZEOF BLDQ NO, Of STORIES �y' <br />; Z�.jz � oN <br />i <br />� fIPEBPRINNLERSPEOUIPED ❑YES RNO <br />� <br />I APPUCATIONAC�:BY VLANS�PV0.BY <br />i �L� <br />7fi — �' -'�` -�-5 � —y.� �SY <br />I HEREBY CERTIFYTHAT I HAVE READ AND E%AMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE Tr7UE AND CORHECT. ALL PROVISIONS OF LAWS AND <br />OFDINANCES 60VERNING THIS TYPE OF WORK WILL BE COMPLEfEO WITH <br />WHETHER SPECIFIED HEREIN OR NOT.THE ORANTING OFA PERMRDOES NOT <br />PRESUME TO GIVE AUTHORIiY TO VIOLATE OR CANCEL THE PRONSION9 OF <br />ANVOTHER STATE OR LOCAL LAW PEOULATIN6 CANSTRUCTION ORTHE FEFF <br />FORMANCE OF CONSTRUC'ION. THAT I AM AUTHORI2E0 BV THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION 18 MADt <br />AND I COMPLY WITM THE STATE CONTRACTORS LAW 1827 RCW AND <br />298200 WAG <br />SIONAfUPEOFCONT IOROR� R2ED�GENT D�TE/� Q� <br />X������e!!�!3rl�t�ilWf—_ ` _ <br />♦PPLIG�NT6 GITY 9USINESS tICEN9E NO. AND BUSINESS N�ME <br />MECHANICAL <br />N0. TYPE <br />p� NC-NHNDLGU <br />— / FORCED AIR SYSI <br />'- .B" UNITHEATERS- <br />CLOTMES DRYER: <br />•' VENTILATION FAN <br />� � RANOEHOOD <br />� <br />a <br />s � <br />sme sera+cn <br />6' <br />V�GNi SIiE <br />O�ES ❑ NO <br />C-'� <br />BUILDING '� - ",�3� X�t- <br />PLUMBING <br />MECHANIGAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />- H.P. <br />- &T.:1. M <br />M <br />SZ <br />a <br />s <br />8 <br />