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-�'APP�.ICAT'ON F�,R �evc�etl � <br />fha Evergreen C O N S T R U�:7 t O N I�► I� <br />CItY OF <br />everett ��E[�MIT �" i <br />TO BE COMPLETED IN BLACK IIJK— PLEASE PRINT I <br />BUILDING DEPT. <br />259•8745 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />owucn Mnanooness r,nr zir P�IONE <br />�DG�E /i���,� /3�/ S,F_. _F�il2�rr-!"incc. Wi�y L�i,2�rT ��s� 3�FB-:3G3�' <br />•RCHIIECIOfi�ES�ONER MAIL�OUItE55 CIIY I�P PRONE <br />OCNER�LCOHiRAC10P MPILAGaP[55 �CfI / 21P P�WN[ �iGENSE• <br />(GM//jy ai/''�;�:TC' /.�,2/ �G �d�rT/y��L/Y �/.E/',.Eii J�i���F 3�[f3-3635 <br />�a�/� - i n/ �— �'Y <br />IuEc��ni�icn�wr�rnnc�on �^������°�5S ��� T�r r��u�E T'N✓.9c�`E�3�?aJ <br />rlUln'J�IIGCOH1RRCi0R MNLRDDlIE55 CIIV ZiP PMJNE LICENSE• <br />C1�55 OP WORK <br />� NEW ❑ �DDITION ❑ P: TERATION ❑ F7EPAIF ❑ DEMOLITION ❑ WOO�S70VEJFRPL.INSERT ❑ BUILDING ACLOCATION <br />ve�w n//o/�� aq� v.,:�on�v ic,o� o� �nni�n nis—PyLUS LA00111 b <br />�lic!Jdv '� I.Z��)_�� <br />oescniof� wonK <br />A/Ft�I �D�J�i%CJC_'�/e.v.I -- — <br />ior_ <br />FA/ZN5 <br />/� G�L,� <br />( PROJEGi <br />LAVA7 <br />USE 101l� <br />��- <br />rrrc o� cor+sr. <br />��� <br />� <br />S �i/ /Cti)'j9L2/c <br />'[_//_'ti//t l i � O �Y �✓pl <br />�J /15 /1Ji ��'. GF <br />u. �'Si v iiv 3W <br />` �� <br />_1/h�. �.�. � <br />//i✓/� <br />5 <br />I HERCBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS AP• <br />PLICATION AfJD KNOW THE SAME TO BETt�UEAND CORRECT. ALL <br />PROVIS�ONS OF LAWS AND OROINANCES GOVERNIIJG THIS TYPE <br />OF WORK WILL BE COMPLETED WIThI WHETHER SPECI�IED hIERE- <br />IN OR NOT. THG GRANTItJG OF A PERMIT DOES NUT PRESUME TO, <br />GIVE AUTHORITY TO VIOLAi E OR CANCEL THE PROVISIONS OF <br />ANY OTHER ST�TE G�R LOCAI LAW REGULATING CONSTRUCTION <br />OR THE PERFORMAIJCE OF CONSTRUCTION. <br />SIGNANREOFCOM(tAC70RORAUTHORIZED�GENi DA7E � ����f( <br />X � � / <br />/ ,���-y,�.R. LU. �cYT�f'7 <br />1PPUC�NTS G/IIY OUS W ESS UC[NSE HO. <br />D�U�T� <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />fif�(15[104GK Si0E5[ID�CH PLANCMECNNUMOF.e ��,�L-ANCHECKiEE <br />^ � / (1{' � fEE /%��— �[LEIPf1j�r <br />t/.+ b f�l l"1 � I�'�[�.� � ! 7 <br />lO1�R[F —" J���- <br />Z/ /(��� SF j�I FSN iRlO FEES VRLUAl10N FEE <br />lJ �yu;l[ �nc� ot e '��.cka.y , <br />or.curnr+ercnour uo.oroweuu+ouNns : f��,y <br />R�'� I M�I I . BUILOING b�/../'�(`�).� �� <br />�i'Lg M• � <br />PLANS CIICCHEJ <br />�� <br />;. IOnD <br />__.. <br />nr r�i. ron issunnce n. <br />� �� • <br />PWhIBIN(3 <br />IAEGII�NICAL <br />07HER ^ <br />1{ <br />rErwuv �� <br />iDTAL <br />''� �(J <br />fEE <br />� <br />