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APPLICATI(�1 FOR CONSTRUCT�'7N PERMIT /�' <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br />I HEATING SYSTEM: ❑ GAS �ELECTRIC J__ — <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />O\YNEF I.IAILAO�f 55 CIiY P PIIONE <br />� ��rGcl �� � 3�,�r�til✓ �-a.�Ile, �� �ln� 5z6 - z-�9I <br />tENANi MAiL�ODRE55 GrtY � ZiP Pi�ONE <br />A/Rb��/jjECT /QRDES�GtlER AIAILADDRESS ���Y ZiP PHONE <br />DG j' LSlh� <br />GENEHALCO AGiOR IAAILRDORE55 ,5 <br />�6na� CoYLf'. ��.�jax �6�( /�k%G,`/deo l� % <br />M[CMANICALCONiRAGTOR MAILADORESS CIiY ZI� <br />niuMAiNGWMRACtOR MAILAUDFE55 ��T� Z�C <br />CLASS OF WORK <br />k NEW ADDITION ALTERATION REPAIF <br />i«< .•.... ' di".�? i'� <br />. <br />CONiRACT PRICE Oi WORK <br />DESGRIBE WORN ANO SOUARE FOOTAGE i'O�LVpED <br />�/� <br />PROPOSED USE OF BUIL�!NG 1 <br />,� ��I L� <br />1 <br />IEGAl�ESCRiPTIONOfPPO�' RT�'ISIIOWNBELO 4RACHFOURCOPIES� <br />LOT Z PLOCK OF ���� ILO� <br />:[QI <br />ADORESS /^ <br />�� � C9 ✓/�J/r <br />iINK 8 DISP ' <br />1ER <br />TRAY <br />ETC. <br />FOR OFFICE USE ONLY: <br />FRONT 5[TB�GN � REAR SETBACH / <br />7� <br />USEIONE LOTAREA <br />ttPC fCON15ALlOWABIE 1YPEOfLONSt.ACNU <br />DGCUPARLYLOA� FlRESPPNKlEHSF <br />FlEASO fORSPPWNL[RS <br />rt�rnn[or e�ar�snranov[o <br />FEE <br />5 <br />�--z6 f <br />3 ��375� <br />PlIONE <br />StAT[ UCENSE • <br />122dNy: <br />STAiE LILENSE � <br />StATE LICENSE � <br />DEMOLITION WOODSTOVE/FRPL INSERT .� BUILDING FELOCATION <br />CONiACT PE(i50N .�ND PNONE NO <br />6a�vtnT.,d L ca�. % 2ec,i- uJZ <br />3 s3 —.� /.�(J' <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOCJ THE SAME TO BE TFiUE ANO CORRECT. ALL <br />PROVISIONS OF LAWS .1ND ORDINANCES GOVERNING THIS TYPE OF <br />� WORK 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 HEGIILATING CONSTRUCTION OR THE <br />PERFORh1ANCE OF CONSTFUCTION. Tf{q7 � qM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />— APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTO LAW 18,27 RCW AND 296.200 WAC. <br />� ''�1b15Z <br />NO. I TYPE OF <br />RANGE <br />� <br />i ' <br />& CHIM1INEY �Q__;= <br />smeseiu�pn/ .��...�� �,.�. <br />S e - _; ,S �� � 3 <br />VACRNi SITE FEES <br />�UILDWG <br />occaruxr xoacnur+;uns <br />LR°'° PLUMBING <br />-3 / <br />BASEMEr+T MECHANICAL <br />O — <br />HEIGH�TLIM¢ITRTIO� ADDITIONALPLANCri4CK <br />!/CJ FfLSwSR- Il /7 L % / V <br />STATE �UILOING SURCH �RGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES — <br />TAX CODE IS 3105 TOTAL <br />RECEiPi N0. <br />? /6. .a z �- 7 `�'v�3 v <br />� <br />� <br />.,,�'y ; i.l <br />' °� n <br />.�,,- <br />,. -`. � �,} � `�•�`.�'n <br />