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I <br />O N <br />i roIn <br />In <br />H O In <br />AWAW I <br />APPLIGrAT1ON <br />FOR CONISTRiCTION <br />PERMIT <br />,•Yrmil <br />are Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />TO BE COMPLETED IN INK-- PLEASE PRINT <br />259-8810 <br />CIM1 ZIP <br />PHONE <br />OWNER <br />MAIL AGDNESS <br />98203_ <br />347-3775/347-543 <br />_ <br />The Casa Group <br />Corp. P.O. Box 2188 <br />Everett, <br />—zip <br />PHONE <br />IENANT <br />AUIL ADDRESS <br />MAIL ApOPE54 <br />GTY ZIP - <br />- PHONE <br />ARGNRECT ON?ESIGNER <br />CITY ZIP <br />PHONE <br />LICENSE • - <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />775 <br />m_L., reRa Groc;i�-w..a. <br />P O Box 7188 <br />Ev� Yet t_.98203 <br />34P17iDNe <br />MECNANIGLCONTRACIOR <br />MAILADDRESS <br />R.,R 98208 <br />355-5171/ROBINCENSE <br />2 <br />P1umh_ <br />607 SF Everett <br />Mall Way <br />nY z, <br />PHONE <br />LICENSE <br />RnhinSon <br />PLOMBINGCONTRACTOR <br />MAIL ADDRESS <br />---- . <br />.,eo_o T IV. <br />/RVF.Rf.SS 121&7 <br />KK NEW ❑ ADDITION ❑ ALTERATION Cl REPAIR ❑ DEMOLITION ❑CONTCONTACTJOODSPERSONONOPNONENOSERT ❑ BUILDING RELOCATION <br />nNANT IMPROVEMENT OR INTERIOR REMODEL ONLY _ <br />10 5 0.00 Pres 347-3775/347=5/_133 <br />CONTRACT PRICE OF WORIL - <br />0ESCRIBEWORKAND SQUARE fOOTAGEINVOLYED <br />Sin le Tamil r 'de <br />PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO ISE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />C ' 1 P a m i1_1 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />LEGAL DE RIPDONOFPROPERTY ISHOWN BELOW OR ATTACH FOUR COPIES) WH ETHER SPECIFIED H EREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />PER - <br />LOT 1.nt ABLocK OF C'7 T 4c M• ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- II <br />FORMANCE OF CONSTRUCTION. THAT i AM AUTHORIZED BY THE OW NER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE •I <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND '.I <br />296.200 WAC { <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT <br />11011 3rd Aven <br />PLUMBING <br />NO. TYPE OFF <br />OF <br />;INK& <br />IER <br />TRAY <br />Lie S. E., Everett, Wa• <br />- NMI!! <br />— BAR. <br />FEE <br />LF <br />NT SR[ <br />S O NO <br />MFCHANICAL <br />NO. TYPE OF EQUIPMENT <br />A/C — A/HNDLG UNITS — H.P. <br />_ FORCED AIR SYSTEMS— BT.U. M EA <br />_ UNIT HEATERS—E.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />FAN <br />XANO <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />3/APfPR BY <br />PUBLIC WORKS <br />: *'" I <br />TOTAL <br />s <br />IS <br />IS <br />3s <br />