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APPLICATION FOR CONSTRUCTItIN PERMIT <br />fM E�srpnsn <br />GTY OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINi <br />259•BB10 <br />❑ DEMOLITION I I COMBINATION I I BUILDIN(i ! I MECHANICAL <br />�y�p M�II WORE69 GTY iIP PNONE <br />everett <br />e <br />id.Ptt1MBIN� f 7 SI(iN <br />/7IJ/tN /i /,IJoN � - --- <br />��T M1�DDRESS CIIV 21P ��F <br />�PCNRECiORDESqNER MMl60DRES9 Cliv I�P P�E <br />OENEMLCONiPACTOf1 M��I�D�RE89 CITY 21P PNONE IIGCN5E1 <br />MlCIUN�GLLCONTMCTOR IMR�ODRESS CIfY 21P �Iqt:E IICENSE� <br />pUMBK1000NTRACTd1 M�R�ODPESS QfY 71P PHd+E LICENbE� <br />� ,, s� s�• � '"s'd /98 �Td io 5` � /l1j�T/,n/'�cis L <br />�,W90 WOfIN <br />❑ NEW ❑ ADUITION OV.ALTERATION I I REPAIR I! DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILDINO RELOCATION <br />TEWWTIMFROVEMENTORINTERIORREMOOELONIV GONtACTPEP50NANOP110NEN0 , - _ . ' <br />pE�,p� ypqK �Np 9p�ARE fOOT�OE INVOLVEU <br />P D U9E OF BUILGINO <br />�� i A <br />LEOILL OEBCPIPTION OF PROPERTY 181qWN BELOW OII <br />�oi --- — e�ocK or _ <br />SINK <br />-� <br />�� <br />I�� <br />�i�� <br />pppNtgE161CN� � RE�RbETB�CN I 61UEfiETB�CR <br />UBEZONE � L0111RE� <br />mf a coxai uiow�eic <br />BW OF BL00, <br />pqCUP�HCY lW D <br />qFA8p1 fUR BPRINNLERB <br />AVPI�CATION �CC. BY <br />iYFF Of C7N51. �CIUAI <br />NO OF B�ORIEB <br />FIIIE 6PRN10.EP5 RE00 <br />[J YE3 LI NO <br />PLAN9 �PPilOVEO BY <br />WGVli BItE <br />I I VFS I I NO <br />OC[UMM[v IqPbMl��M011Yi�� <br />a�auv <br />BASEMF.NI <br />I I YES ! I NO <br />HEqHT LIMI1�fION <br />CITY OF EYEHETT <br />LOCAL SALES <br />TAX CODE 18 3105 <br />I HEREBY CERTIFY THAT I N 'E READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE Sh�.iE TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES �OVERNINa THIS TYPE OF <br />WORK WILL UE COMPLETED WITH WHEIHER SPECIFIF.D HEREIN OR <br />NOT. THE GRANTINO OF A PERMIT DOES NOT PRE�UAIE TO CiIVE <br />AUTHOHItV TO VIOLATE OR CANCEL THE PAOVISIONS OF ANY <br />OTHEH STATE OR LOCAL LAW REOULATINA CONSTRUCTION OR THF. <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNEF OF THIS PROPEHTY TO PERFORM THE WORH FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />COhTP.A�TORS LAY! 1827 HCW AND 296200 WAC. <br />BqN�TUPEtN':d11R�CfOROHAUT1qHRED�OENT D�TE <br />X <br />HOOD <br />PLNI CHECH NUMBEfI <br />auaov+o <br />PLUMBINO <br />MECHANICAL <br />pTHER <br />S7AT[ BUILDINC FURCNRR6E <br />STATEENERGVSURCNAROE <br />PUBL'C WORKS <br />TOTAL <br />•ND WSINE86 <br />u <br />£UB TOTAL 5 <br />PERMIT S �__ <br />TOTALFEE S ' <br />fEE flECEIPTNO. <br />VALUATION FEE <br />� <br />� <br />_ ; <br />ya � — <br />i <br />r— <br />i <br />� <br />