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APPLICATION FOR CONSTRUCTION PERINIIT � <br />TO BE COMPLETED IN LACK INK—PLEASE RRINT <br />HEATING SYSI �M: ❑ GAS ❑ ELECTRIC U__ <br />BUILDING DEPARTivIENT <br />259-8810 <br />DEMOLITION COMBINATION �' BUILDING JrMECHANICAL LUMBING SIGN <br />ONTJER MAIL 4�ORE55 GiY 21F PNONE <br />NZC NCC � �9 t�tPl�. ir Bcv P�fJ Z�urr4rT 3-.�; oS <br />7ENRNT NAIL ADDFE55 GITV ZiP p <br />CL• ^ PHOYE <br />ARCHITEGTORDESIGNER MAILAODRESS ��T� Z�P <br />GENERAL CONiRRGTOR MAM1 ADDNE55 CITY ZIP PNONE STATE LICENS[ t <br />Own�l� i�OJrR�9rro�2 <br />��n, Z�p PNONE STRTE L2ENSE / <br />MECHANICAL CONTRPG70R MR�L PDDRESS <br />�/ <br />UCT <br />/' <br />ADDHE55 <br />CLASS Oi WOFKy <br />� NEW /X ADDITION ' AITERATION REPAIR <br />�ESGRIBE WORK R�`SO�nHt Fwia�c mvin.c� <br />2rs'b NE�.�' <br />PROPOSED USE OF BUILDM . <br />LEGAL OESCRIPTIO' R N GYF FPOPENTV ISHOWN BELON OR ATTACH FOUR APIES) <br />�oT 27� z8 a�aK zs _ oF r=+eao.rs r s� <br />- r--- L/o 3 PN! E 3c� / <br />� <br />c, .�.1.n.�r1sH—' �OVh/Ti <br />� yS/y�-azs' —n�r�_ <br />BATHTUB <br />LAVATORV�WASH BA; <br />SHOWER <br />KITCHEN SINK & DISP <br />FOUNTAIN <br />FOR OFFICE USE <br />FR�NTSETBhGN <br />20 <br />usE zone _ <br />O� BIDG. <br />INTNKE <br />SUB TOTAL S <br />PERMIT 8 <br />TOTALFEE S <br />SETBRLN SIDE <br />%C <br />Gltt tn <br />PMONE STr1TE LIGENSE � <br />WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />AND PNONE NO <br />.3•S3 - '3S"•S /��< <br />� HEREBY CERTIFY IMAI I n/ivt ntNu nnv ���.����.�.. •.••.. <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF LAW� AND OFDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPLE?ED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV 70 V'OLATE OR CANCEI THE PROVISIONS OF ANY <br />OTHER STF.TE OR LOCAL V+W REGULATING CONSTRUCTION OR l'HE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH TF:E STATE <br />CONTRACTORS LAW 1927 RCW AND 296200 WAC. <br />x �%C1-- ��/� //-ia ^4� <br />s�cNn o�r� <br />C�LY BOSMHS LICE' iE NO <br />UNIT <br />FAN <br />FAN <br />I(7 ,S � NV BUILDING <br />fYFF Of GONSi. AGiOAL occov�y« N9 0� mV[uwL UN�15 <br />°^0ij° 3 PLUMBING <br />No.oFSTORiES BnSEMENT MECNANICAL <br />ADDRIONALPLANCHECK <br />FIRESPRNKLEHSRWU NEIGHiLIMITAt10N __ <br />SPRINKLER <br />STATE BUILDING SUFCHARGE <br />PUNSAPPROVEDBY ��TY OF EVERETT PUBUC WORNS <br />LOCIIL SALES <br />TAX CODEIS 3105 TOTRL <br />�B.T.U. M E.A. <br />M <br />FEE <br />�� <br />a <br />