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M�Ewrpn�n <br />CIIY OF <br />everett <br />BUILDING D[PARTMtNT <br />259•8745 <br />',-.PPLICATION FO��� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />everell <br />� <br />❑ DEMOLITION [� COMBINATION O BUILDtNG O MECHANICAL ❑ PLUMBING ❑ SIGN <br />�yHER MML �OOHESS LITY ZiP PNONE <br />.___,_....__..�_.._�.,... T.,,. iu�n� R�rhall F.VPTPY�' Hwv k2 Sothell 98012 481-8866 <br />�aCNrtE �oeoesmncn — - � <br />%� F / ' ' '�1�'lc� �� f5 ��/_S—GSE <br />OENEP�I CONiR IOP MML ��ORESS C11V ZIP PHONE LIGENSE • <br />Lessley ConstrucCion LESSLI#210PK <br />MECN�NiC�LGONTP�GTOq MAIIADDRE34 LITY ZiP PNONE 4GENfiE <br />Same <br />iWM81N�CONLflAC10R M�II.RDORESS G1Y ZiF PIIOHE LiCENSE� <br />Robinson Plumbing _ 743-9858 <br />CUSS Of YIORN <br />� NEW C� ADDITION ❑ ALTEFiATION ❑ REPAIR ❑ DEMOLITION ❑ N'OODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />V�W�1iON OF WORNIGOSi Of MRI'OI�LS PLU9 L�BORI <br />� Lj - <br />DESCPIBE W N <br />New single family residence _ ���/� �09� _ <br />LEO�L DESGRIV➢On or rxui <br />ior 1 o�oc�_� <br />ttPE OF CONSt. <br />� I I HEREBY GLRTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT.ALL <br />IY�SMOWNBELOWORAITACNFOURCOPIE51 p�ROVISIONSOFLAWSANDORDINANCESGOVERNIN6THISTYPE <br />Willow Creek Glen UFWORKWILLBECOMPLETEDWITHWHETHEHSPECIFIEDHERE• <br />IN OR NOT. THE GRANTING O� A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF' <br />.4NY OTHER STATE OR LOCAL LAW ��EGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. � <br />51:3NRTURE OF CONTRACTOR OR AUTHORIZEO AGENT UATE <br />��l <br />FEE <br />X <br />NO <br />M <br />M <br />1"HIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />RVPIIC>ilOtl �CC BV <br />PERf13ETB�LK <br />�Ot nf1EA <br />O!: W PRNCV Gf10UP <br />N9 01'SIONIE9 <br />F[D ❑ YES ❑ <br />. PLnuS CHECNED BY <br />VACRNI SIiE <br />❑YES f]NO <br />NO. OI' DNEL <br />fOR <br />NUMBER <br />BUILD:NG <br />PLUMEING <br />MECHANICAL <br />OTNER <br />PENRLTV <br />TOT�L <br />`� . � � � . ' . � , � �� <br />FEES <br />FIRN CNECKfEE <br />GEE L�^� REGEIPT NO. <br />ti 1�. <br />V�Ll1�TION FEE <br />� <br />