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CONSTRUCTION <br />the Evergreen <br />CITY OF <br />PERMIT <br />everett <br />1 CITY HALL 2558745 <br />COMBINATION <br />BUILDING MECHANICAL <br />PLUMBING <br />EVERETT.WA BB2o1 <br />JIP <br />i'IIUNL <br />OWNERm <br />f•1IL`t4'RD Sim ATID - <br />ADDF :SS <br />PHONELICENSENOARCHITECT <br />ORMAIL <br />MAIL ADDflESS� <br />OENERALCONTRACTOfl <br />MAIL ADDRESS FHONE <br />MECHANICAL CONTRACTOR <br />IT <br />❑COMBINATION <br />❑BUILDING ❑PLUMBING ❑MECHANICAL NEW❑ADDITION ❑ALTERATION ]REPAIR <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />LOT BLOCK—OrJOB ADDRESS1909 trn�nJz <br />PLUMBING <br />TER SERVICE SI <br />SPECIAL CONDITIONS: <br />BLDG. SUPPLY <br />❑YES ❑NO <br />MECHANICALTYPE OF ENERGY ❑GAS ❑ELEC. <br />L <br />FAC. BUILT FIREPLACE & CHIMNEY <br />TOTALFEE SITHISPERMITBECOMESNULLAND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS. OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTERWORK 15 COMMENCED. <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION CT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNNGKNOW THE SAME TO BE TRUE AND RTHS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />x12/12/77 <br />SIG ATURE OFC TR ORAUTH. AGENTDATEPLAN CHECK NUMBER PLAN CHECK FEE <br />FEE IRECE'PTNO <br />]CC.LOAD BUILDINOPLUMBING <br />PRINKLERS <br />IRED MECHANICALES ❑NOOTHER <br />PENALTYTOTALPERMITVALIWHEN PROPE <br />S <br />SEC. 307(e1 <br />100DATION t D p� yll "•' Pr Mli3 <br />SLY VALIDATLD IIN I AGE)7qjL <br />i � <br />ACDRESS FILE <br />