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APPLICATION FG.t <br />PV <br />o <br />,Y OF <br />r °'" <br />CONSTRUCTION <br />CRY <br />everett <br />PERMIT <br />TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br />BUILDING DEPT. <br />?59.8746 <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />❑ PLUMBING ❑ <br />SIGN <br />ANWR <br />MAIL ADDRESS CITY TIP <br />. �i <br />24 mnlr: L.r <br />L <br />PHONE <br />FL 10 L� 3 <br />- •, Ord <br />/ n♦♦LL <br />��'� \T:NI�Kl1 <br />+,a I'S <br />L_��l CIIY� SIP <br />PIIONC <br />RCNIT[CT pR OE910NER <br />MAIL AODRES! <br />/ <br />CITY SIP <br />PHONE <br />l CEN9E <br />MAIL ADDOES9 <br />` Cart CITY TIP PHONE LICENSEIECHANICAL CONTRACTOR MAII AODRE9! <br />I ✓ If Av f`JGyy1nQ�SJTu r• ft 5tz r r f� IvsVz3 <br />LUMSINO CONTRACTOR MML AODRE!! CITY TIP P ONF IICE 1 E <br />z 1-� �-i 2G I a(•� �D ILL AID nre �•-I h1(•1U f (4223 <br />.LASS OF WORK <br />KNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERi BUILDING RELOCATION <br />ALUATION OF WORK (COST OF MAMMALS PLUS LABOR) <br />/ . .,.. A I I J'I ) <br />514I.LS/ FA m I I-L I P t. - c E. <br />19E OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP, <br />� � �� PLICATIONAND KNOWTHE SAMETO BETRUE AND CORRECT. ALL <br />EOALDElCRIRION Or PROPERTY 1914OWN BELOW OR ATTACHFOUR COPIEM PROVISIONSOF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL 13ECOMPLETED WITH WHETHERSPECIFIED HERE- <br />OF aeLoeK_-or IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />/�'10 %�I ALAI LIIEII� OI1J �S ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />i 1 - OR THE PERFORMANCE OF CONSTRUCTION. 1 <br />SIGNATURE OF CONTRACTOR OR_AUTHORIZED AG Nt (°ATE ILSIk <br />9074` <br />4 o <br />SI'4 TOTAL S <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />PUNCIIECK HUNKER nO 2�-- <br />REAR 9E IRAf,K flirc <br />SIDE BFIIUIC RECEII <br />J i 1 • �r I y �O'Cl\•:q <br />Or.r FIL9 �l : . (_ <br />IA 4�L s, t <br />P, 3, IVA <br />IOOIES <br />I <br />VAOA4I SHE <br />nrrs GNo <br />NO Or OWEL <br />I <br />E'/6 1 1)j,g1)1 1 Z- It . <br />rEU <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />/VG 33 <br />VALUATION <br />!' )'Ti STj1 <br />C/.I r� Ir <br />m <br />