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�M Ewrprr� <br />riTY OF <br />everett <br />OUILDING DEPARTMENT <br />259•8745 <br />�.PPLICATION FO��' <br />CONSTRUCTION <br />FERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />J DEMOLITION K�COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ ALUMBIN(i ❑ SI6N <br />'4NER M�IL�DDRE53 CITV iIP PHONE <br />Lessley Construction, Inc. 18204 Bothell Everett }Iwy #2 Bothell 98012 481-8866 <br />— ...�� ......,«� ciTv 21P nHONE <br />�ENER�LCONI� CIOA M�ILAD�RE55 ��TM ��P P�u�E LESSLI;E`�i�JP[C <br />I,essley onstruction, Inc. <br />�ECN�NIG�LGONTP�GiOq MRILR�ORE55 CITY ZIP FH(iNE 4CENSE• <br />Same -- <br />LUMBINOLONIR�CION M�ILPODNE55 CITY ZIP PI!ONE LICENSE• <br />Robinson PlumbinA 743-9858 <br />1A900f WORN <br />Jf,� NEW ❑ ADDITIOti ❑ ALTERATION ❑ REPAIR ❑ DEMOLI710N ❑ WOOGSTOVE/FRPL.INSERT ❑ BUILDINC HELOCATION <br />4 W�iIOH Oi WORN �C09T Of MMCi11�L5 VLU9 L�BORI <br />ESCRIBf WONN ' <br />SinRle famil <br />seorauaowc <br />�G�L OESCRIPiION OF <br />�r 25 e�ocK— <br />1529 Slst P1. S.W. <br />GI� <br />E OF BLOG <br />OF <br />f_ <br />I HEREBY CERT�FY THAT I HAVE PEAD AND EXAMINED THIS FP• <br />pLICATION AND KNOW THE SAMETO BE TRUEAND CORRECT. ALL <br />BELOWORATiRCHFOIIRCOPIE51 pqOVI510NSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br />Creek Glen OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br />— IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAVY REGULATIMG CONSTRUCTION <br />OR THF PERFORMANCE OF CONSTRUC710N. <br />SI�NATUREO CONTRACTORORAUTHORIZEOAGEN7 0 TE <br />,j ,� � <br />X �1 /1 f,,r�77/.I o �.i J� /� <br />FEE <br />UCENSE NO- <br />r.r <br />M <br />M <br />S <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />AGC BV <br />LOi RfVER <br />CMF.CREO BY <br />� <br />SIDESEIBACN PUNCHECNNUM9EN <br />`r^ /�/, ,I FEE <br />�� W ( � <br />VRCRNT SILE FEE8 <br />OYES ONO <br />MA%.00Q LORD <br />BIlIL01NG <br />PLUMBING <br />MELNANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />5 <br />RECEIPi NO _ <br />FEE <br />