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APPLICATI��N FOR CONSTRUC'�tibN PERMIT <br />everett <br />IM E�+rp�wn � <br />CITV OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT ' <br />259-8810 ! <br />❑ DEMOLITION C7 COMBINATION I I BUILDINO I i MECHANICAL I I PLUMBINO f� SION � <br />O�Eq M�ILAUDRE59 CITV LP PNONE , <br />►u'[�N �ih� WONCt 111 NE IS%5T SEA1f�E Wl'� `'18.?.ul C�oC).ZS`j-2//2 _ <br />...... crtv ZiP �IKK�E <br />� <br />cnr <br />CITY <br />/� L <br />CITY <br />PIIONE <br />PNONE <br />` LE i <br />, <br />PHONE <br />pUJL191NOCONTPACT011 MI11l�UDRF.9S CI7V IIP PIKKlE LICEN6E1 <br />I�l NEW ❑ ADDITION <br />TENMlT IMPROVEMENi q11NiERIDR REMODEI ONIV <br />I wr �� � <br />FIIONT BETBACR <br />E <br />UBE I0� � <br />�t i <br />G� <br />ME q E0115T, /�IIOWMIf <br />lIZE Of BLDO. <br />S�'X� 7� <br />occuru�cr �ao <br />Z11 <br />RFABpI FOH BFRINNLERS <br />�ppuc,var� �cc er <br />IY`� <br />6 <br />I I RF.PAIR I 1 DEMOLITION I I WOODSTOVE/FRPLINSERT LI BUILDINORELIxATION <br />SUB TOTAL E <br />PERMIT S <br />TOTAL FEE S <br />PEAP BETBACK BIDE 6EiB�CN <br />lOiAREA <br />NO.OF ETORIEB <br />1 <br />fIRE BPRNNLFRS PEO'D <br />U VES K NO <br />PlANS �FPPOVEO BY <br />V�CNIT BITE <br />Dd YES f.1 NO <br />A=31 "'— <br />BASEMENT <br />� i ves ryer+o <br />HEqNT LIMII�IION <br />CITY OF EVEflETT <br />LDCALSALES <br />TAK COUE IS 3105 <br />CdJT�CT FERBdI �ND VNONE NJ <br />I HEREBV CERTIFV THAT I HAVE REAO AND EXAMINED TMiS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi. ALL <br />PROVISIONS OF LAWS AND ORDINANCES fiOVERNINO THIS TYPE OF <br />WORK WILL OE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW flEQULATINO CONSTRUCTION OR THE <br />PEIiFORMANCE OF CONSTRUCTION. T: �AT I AM �UTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PEHFORM THE WORK FOR WHICH <br />APPLICAiION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIONATUREGFCONTMCTORIXI�UTNONIZEU�OENT D�TE <br />X <br />UNIT <br />AIR <br />BUIIDINO <br />PLUMBINO <br />MECNANICAL <br />OiHER <br />STATE BUILOINO SURCNRR4E <br />SiATEENER�VSURCNAROF <br />PUBIIC WORNS <br />T0TI1L <br />FEE <br />a <br />FEE <br />S <br />_ <br />� � ,.r�.,,..._...,..... , . ... .._ _ , . .._. ., ,., - <br />%J <br />0 <br />