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� �y � <br />A�lx <br />�H[~i� <br />K � n <br />H �f <br />� � '�U <br />VJ N <br />�Xp <br />HC7 <br />GN <br />H�g <br />QY (] <br />C"H� <br />HH <br />gy <br />ocyv� <br />� <br />�� <br />� <br />1 �� <br />�� <br />�'; APPLICATIGrI FOR CONSTRUCT�ON PERMIT �'``'"'" <br />�, ,� ,. .,,� TO BE COMPLETED IN INK—PLEASE PRINT � <br />GITY OF <br />everett � F;EATINGSYSTEM UGAS JELECTRIC ❑ __ <br />BUILDING DEPARTMENT <br />259-8870 <br />DEMOLITION ' COMBINATION XBUILDING MECHANICAL <br />o11'NtR n1AILADDRE55 CIiY ZI0. F� <br />PLUMBING SIGN <br />� 1 l flfZ% � — �` <br />�.cRNa �.-vr` /�/E•�1-`�•-rs-�.Goik'/ �u�rn,s� G i� <br />TENANi MARp0�RE55 GITY ZIP FNONE <br />�/n,ve <br />ARC111i[CLOl10ES�GNER AIAILROOPESS CITY ZIP PNONE <br />A�c .� t� --- - <br />.:ENEMLLONiRAGTOP MAIIApORESS <br />/�'�.�..z.�. ���y;ii,�f:�c'c.��<� /So d'.a� <br />h1EC11ANICALC NTPAC R IAAILAppRE55 <br />PLUMBINGCONTR�GiOR MAILROpRE55 <br />� NEW �� ADDITION . ALTERATION X REPAIR <br />1 \ <br />,31., ccc <br />CONiR4Ci PRICE OF WOPe _ <br />OESCRIOEWORKqNOSOUAREF00TAGEINVOLVED „ <br />mli <br />Pf1plEGT <br />NO. <br />2piP PHONE <br />/ti1[`7 ��i7-Y:1.7�2 <br />IiP P��ONE <br />ZIP PI�ONE <br />DEMOI.ITION WOODSTOVE/FRPL INSERT <br />CONiACT PCRSON AND P110NE NO <br />UCENSE� <br />111Ai'.[ 3-.f" � t� 3 <br />UCENSEi <br />LICENSE • <br />BUILDING RELOCATION <br />�i/� !�A /+� /� 6�G ( / " ti :; <br />.ort+c - I HEREBY CEfiTIFY THAT I HAVE READ ANO EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPERiY (SHOWN BELOW OFATfACN FOURCOPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE C01.1PLETED WITH WHETHER SPECIFIED HEREIN OR <br />eiocK oc 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 REGULATING CONSTRUCTION OR THE <br />PERFOflMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICIi <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORSLAW1827RCW AND296200WAC. <br />SiGNAIURE OF GONiPPCtOR OR AUiHORRED AGCJ1� OAiF <br />\X �O �/-��. � <br />SINK 8 �ISP <br />TRAY <br />DRAIN <br />.OW PflEVENTERS <br />FOR OFFICE USE ONLY: <br />fRONTSEIpACK REPR: <br />US[ 20�+E <br />nve ov cor <br />s¢e or oi <br />OCLUPANI <br />R6�WNF <br />rt�rnK[ nv <br />SUBTOTAL S <br />TOT�L <br />OF STOR�ES <br />r�ar+s nraaoveo nr <br />FEE <br />MECHAN�CAL <br />— NC—NHNDLG UNITS— <br />— FORCED AIR SYSTEAIS <br />UNI7 HE�TERS—B.T.U. <br />CLOTHES ORYEPS <br />— VENTIL4TION FAN <br />RANGEHOOD <br />W/1TER HEATER <br />Vl00� STOVE <br />METAL FIREPLACE & C <br />FIREPLACEINSERT <br />HEAT F'UMP <br />EXHAUSTFAN <br />PLAVCMEGNNUMBER <br />3 SY?-o: <br />BWLDING <br />:po�NCY NOpRhSLLiAiLW15 — <br />'Pb''P PLUTABING <br />SEMENT MECHANICAL <br />IGHTLIMIiAT10N AD�ITIONALPLANCHECK <br />OTHER <br />STATE BUILDING Sl1RLHARGL <br />CITY Of EVERETT rueuc wor.Ks <br />LOCALSALES <br />TAX COOE IS 3105 TOTAL <br />T.U. M <br />�TAL FLE 5 � i S <br />RECF.iPT NO <br />4LUATION FEE � <br />E t« .�3C'� � �" <br />/S��vc <br />.r!o� <br />3� yi s� <br />