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�l,��PLICATION FOR-.� <br />'".E'.,°"'" CO �I ST R U CT I O N °°°'°" <br />an oc <br />everett PERMIT � <br />BUILDING DEPARTMENT <br />259•8745 TO BE COMPLETED IN INK- PLEA"' "'I''T <br />❑ DEMULITION <br />��� <br />�.nn <br />❑ CnMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />M�ILRDDPE59 CITY ZIV PHONE <br />'/d <br />� <br />4ENER�LCONTq11GTOP M�ILAO�RE55 CITV 21P PNpNE LICENSE• <br />�lP.C�>m B�mi� ��t�e,N vf`%h -�iYS/fc�� /s,��o.as ,�Ir",C�ln1� /�aP7 <br />MECN�NIL�LCONIN�GiOl M��LADORESS CI1Y Z�P PHONE LILENSE• <br />PLUMBINfi COHifUCTOR M�IL AO�RE59 CITY 2iP PIIONE LICENSE • <br />�RU <br />�ISE <br />fYPE <br />SIiE <br />❑ ADDITIO� ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑\YpODSTOVE/FRPL,INSERT ❑ BUILDING RELOCATION <br />II9E WOHK n� <br />iIc C✓ Cye�S T <br />euamNa <br />.yn..r, y�_ <br />�ESCRIPTION O� f'qOPEHiY IS/HOW �I BELOW OR �1T <br />i� _.__.. __ /<?.r� /�ip <br />%0 .5��.�d .S�" <br />eooaEss <br />HEATER <br />I HER�BY CERTIFV THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORREGT. ALL <br />coa�es pROVISIONSOFLAWSANDORDINANCESGOVERNINGTii:�TYPF <br />/,�✓�9�T OFWORKWILLBECOMPLETEDWITHWHE'.HERSPECIFIEDNERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />61VE AUTHfJRITY TO VIOLATE OR CAN^EL THE FfiOVISIONS OK <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SI�NATURE OF I:ONiRACTOR OR AUTHONIZEO AGENT OATE <br />.-� "Ti� � X..f�.� . /����,.z. /1a.e.. / �k'O <br />AC. <br />EA. <br />M <br />THIS PaRTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />RERfl SEBRLK SI�E SE7BFCN PL�Y CHECK NUMBER PLpN CNECK FEE <br />�U �� � �!-9 1�I/ i.� FEE/—J,�1+ REGEIPTNO.S <br />LJ / � ��_i / <br />?—,� LOi ARER �/ � ❑ ESN�NO FEES V�LUIITION fEE <br />/ <br />CONSi <br />�'c-u <br />v <br />APPUCRIION �CC <br />� <br />OCCUPaNCYGFOUP <br />N- � <br />NOAF SIORIES <br />d <br />PLANS CIIECNE� <br />) <br />�� <br />.� <br />CC.LOAD <br />�A <br />FOii ISStIRNCE BY <br />C �G <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHEfl <br />PENALTY <br />TOT�L <br />f `ic�•`�I l <br />_ <br />�� <br />