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� � <br />H <br />YyN <br />� <br />K�n <br />'�tlH� <br />yyo��x <br />QHC <br />O <br />��g <br />t"y� <br />HH <br />gy <br />C� 5t7 ti <br />L'1�+ <br />HOy <br />APPLICATIO[ �'EOFi COfd$TRUC41' � -Id PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRIi4T <br />HEATING SYSTEM: U GAS ELECTRIC 0 <br />BUILDING DEPARTMENT • <br />259-8810 <br />17 DEMOLITION Il COMBINATION I I BUIL�ING I I MECHANICAL I::I PLUMBING ❑ SIGN <br />owNrn Mnanooness cnv zm PI10NE <br />}IOUSING AUTHORtTY OF THG CITY OF EVBRETT 1401 POPI.AR EVERHTT 96201 (206)258-9222 <br />iBNANi unanooness CIIV 21P PIIONE <br />nncmrecronoesmrven ,.uanooncss cirv zm ri�one <br />TNE DYKEMAN 1602 HGWITT AVfi EVERGTT 98201 (20G) 259-3161 ;� <br />ceneYn��r{��nei�p3. ING�ry���stl S. GRAHAM ST ��T�L'ATTLE }g108 (2CfG �JG4—OI�T��IGENSEI e+ <br />� YUNSCI*09�7'CD <br />uec��uaicn�coNmneTon �.uanooness aTr zm ruo�+e STAIELICENSE� <br />SAD1E AS ABOVE � <br />PlUM01NGCONTMCTOf1 MAllA000F55 CIIY ZIP PIIONE STrTEUCENS[� <br />SAPIE AS ABOVE ' <br />c�nss oF vronK <br />IJ NEW I� I ADDITION I I ALTER�TION I I REPNR <br />nrio sounnE roornce irrvavco <br />�een� oescmrrqN oF rnoremv �si+rnm oe�o� <br />L0T OCN OF <br />329 Poplar Steet <br />F91J:� <br />BACKFLOW <br />F9IJ3 <br />FOR OFFICE USE ONLY: <br />F(10NT SETOACK IIEAfI: <br />SRE UF <br />IIC�SON FOO SPOINNLCIIS <br />l01 AtIG <br />I I DEMOLITION I I WOODSTOV[IFRPL INSEflT I I DUILDING RELOCATION <br />� CONL�CT P[IiSON /J!D I'110NB N0. <br />� HEREBY CERTIFY THAT I H�VE READ AND EXAMINED THIS <br />APf'LICATION AND KNOW THG SAME TO OE TRUE AND CORRECT. ALl <br />vounwries� PROVISIONS OF LAWS AND ORDINANCES GOVERNIN�'HIS TYPE OF <br />� WORK WILL �E COMPLETED WITH WHETHER SPECIfIEJ NEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESIIME TO GIVE <br />AUTHORITY TO VIOLAT[ OR CANC[L THE PROVISIONS OF ANY <br />OTFiER STATE- OR LOCAL L�W REGULATING CONSTRUCTION OR THE <br />PERFORMANC[ OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROP[RT' TO PERFORM THE WORK FOR WHICH <br />�PPLICATION IS MADE AND I COMPLY W�TH THE STATE <br />CONTRACTORS LAW 18.7.7 RCW AND 296200 WAC. <br />SUDTOTAL S <br />PERMIT $ <br />TOTALFEE S <br />IOE SEIDnC <br />VACNII SIIE <br />Of CONSI. ACIIIAI <br />FEE <br />oauruw.r I xouuwtwxcivmz <br />WIM • <br />�acn�sn�es <br />TAX CODE IS 3105 <br />se;nn�m�e � 1 I . 7` L�� �JI w I I' Z� 1�i <br />MECHANICAL <br />NO. I <br />8 <br />GAS PIPING <br />OUILDING <br />rwMmNc <br />MECHANICAL <br />ADDITIONAL P�AN CHGCN <br />SPRINKLEt7 <br />STATE OUILOING SURCH�RG[ <br />PUOLIC �YO(1NS <br />TOTAL <br />M <br />SUOTOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />ree nf <br />FEE <br />i <br />T <br />