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� APPLICATIOnI FOR CONSTRUCT""�N PE�MIT �����" <br />me e�w�v���e� TO BE COMPLETED IN INK—PLEASE PRINT � <br />GTV OF _ <br />everett HEhTING SYSTEM: GAS ❑ ELECT IC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />°' DEMOLITION COMBINATION BUILDING ECHANICAL PLUMBING SIGN <br />%'�iHl%.., « r�ni��ci��sri 1... ��� /. ,cir�li.Ae•.-s�, /C 'L�.J_J �N'� 1 'f+ %/CG _ <br />��A <br />W � <br />y�^ <br />R�� <br />�o�� <br />M � <br />Q• <br />�M <br />I�F <br />un N <br />w u <br />O� <br />. .�...r.. <br />1 <br />ARLNILECiORDE5IGNER MAIIRDDRE55 /� ���Y `r ���-��- <br />GCNERALbONTRACiOR MnILADDR[$5 <br />I V Litt ZIP PNONE LICEHS[I <br />CLASS OF WORN <br />�, , NEW �� � ADDITION <br />CpNiRACT PRICE OF WORK <br />DESCN WQRK AND SOIIAR[ F <br />uX n'ki�rc ��i <br />PRO�'OS[D USE OF BURDiNG <br />�pT BIOCK <br />.��1� V � ^c <br />�(ITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />OFINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />FOR OFFICE USE ONLY: <br />FRONTSETOACK REPRS <br />USE ZON= LOT AF <br />1rPC0{CDIIfS.AIIOWI,BIC iYPEOf <br />SI2EOFBlDG NOA( <br />OGCIIPANGYLOIO FlRES <br />aEA50N FJR SPRMrcLERS <br />INIANBBY PLRN$ <br />oF <br />IYi�:J <br />TOTAL <br />ACNRI <br />RW0 <br />REPAIR � DEMOUTION . WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br />..�1 I LONTACi PEPSpN ANO PNONE NO. /�J � _��J <br />`� /� .nl�il /—T ih�Mii'` <br />FEE <br />5[iBALH <br />���� ���: <br />I HEREBV CERTIFY THAT I HAVE READ AND [XAMINED THIS <br />APPLICATIOY AND KNOW THE SAME TO BE T(iUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINCa THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL TI1E PROVISIONS GF ANV <br />OTHEF STATE OR LOGAL LAW REGULATING CONSTRUCTION OR TNE <br />PERFORMAIJCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS h1ADE AND I COMPLY WITH THE STATE <br />CC'NTRACTORS I.AW 18.27 RCW AND 296200 WAC. <br />SIGNRTIIREOFGONiRACiORORNUiHORIZEDAGENT DATE <br />X �v A /� _ _ _ . �n�, i7'� .,,.- �'�i�%�i <br />T.U. <br />CLOTNES ORY <br />VENTILATION I <br />RANGEl100D <br />M[7AL FIfiEPLACE 8 <br />BUILDING <br />oauvmcr ua o�oaurveu�ns <br />caouv PlUM01NG <br />BASEMENT MECHANICPL <br />N[IGNi LIAIItATION ADDIi'OIJAL PLAN CHECK <br />OTHER <br />STAIE DUILOING SURCNARGE <br />CITY OF EVERETT PUBLIC WORHS <br />LOCAL SALES <br />TAX COUE IS 3105 TOTAL <br />ANOOUSIN�SNAME /��/[?L <br />SII�TOTAL S �J' <br />PL9MIT 5 � <br />TOTA�FEE b �i/7;' <br />FEL I RECEIPLNO. <br />, — <br />