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^ <br />APPLICATIQ►. FOR CONSTRUCTI� �N PERMIT <br />TO BE COMPLETED IN INK—PLEASE PRINT U��C <br />rrre E�erg,ee� <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />HEATING SYSTEM: ❑ GAS � ELECTRIC ❑ <br />everet[ <br />e <br />259-8810 <br />DEMOLITION COMBINATION lCBUILDING MECHANICAL j(PLUMBING SIGN <br />OWNER M�ILADDRESS GIT" 21P PNONE <br />5U� GREFJJE Zl S�u,vv�✓E' ����L.Ti 9SZ�,3 ,3`i7-lo(ot�/ <br />TENRNT <br />MRILADORE55 CITY 21P PHONE <br />nRGHITECTORDES�GNER MRILpDDRE55 <br />CITY ZiP PNONE <br />GENEIH,�LCONTNACTOR MAILA�DRE55 GTv ZIP PHONE LICENSEt <br />�YE/�7TGLI/GD�S IA1C SzDGgUPJ��REEAI WHy �'I/CREiT ��3 353-7/G/ E✓-E�f.bat�oi PH <br />MECM�NICRLCIX:TRRCTOR MRILADDRE55 CITY ZIP PNONE UCENSEI <br />PLUMBINGCONTRnCTOR MAILAD�RESS GTY Zlf' PNONE IIGENSE� <br />CLASSOF WOR1c . <br />'' NeW X AODITION ', _�'. ALTERATION �. . REPAIR .�. DEMOLITION �. � WOODSTOVEIFRPL INSERT .-� BUILDING REL I <br />CONTRAGTPRICEOFWORN�/S �Op <br />DESCPIBE WORK AND SOUARE F T�GE INVd <br />PROPOSED <br />lOT ��� IO BLOGK �JQ� OF <br />Go <br />�{ #uT�ury <br />� pTTpCMFOURCOPIES) <br />B�K ods�-D-oo <br />TCk/ 5 �o FT G <br />CONT�GT PERSON AND PHONE NO. <br />R/FF ,'7�NES 3S.g-7�G � <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED VJITH WHETHER SPECIFIED HEREIN OR <br />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 />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />FOR OFFICE USE ONLY: <br />FRONTSETB4CK RERRSEIDRCN <br />�' Z S� <br />USEZON[ IOiAPER <br />-S 27z �i�, n <br />iYPEOfLONiSAILOWPBIE 7YMOiGONSiFLiIIRI <br />S�Z�p�, NOAF STORI[5 <br />'3�5 5P � <br />OCCUPANCYIOP� FIRESPRNKLERSR'. <br />REFSON FOR SPRINNLERS <br />py I P�ANS R�ROVED BY <br />� <br />iIDE SETBACK PUN CNECN NU <br />, � <br />VALRNT S11E FEE <br />� BUILDING <br />occwe�.a waaa+uuxcuvns <br />�°03 / pLUMBING <br />BASEMENT MECHANICAL <br />�J ADDITI NAL i <br />HEIGHT LIMITATION <br />1 ... f <br />r�x <br />OTHER <br />STATE BUILDMG SUFCHARGE <br />jETT PUBLIG WORKS <br />ES <br />3105 TOTAL <br />.�- <br />39;65 <br />