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APPLICATI�1 FOR CONSTRUC7�N PERMIT <br />CITV OF EVEFcTT • BUILDING DIVISION <br />�200 CEDAF STPEET • EVERETT, WA 98201 • 257-8810 7% <br />r DEMOLITION '-i COMBINATION f7 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS , . <br />. .. if YIMJIIE <br />����i�ln � (1 (�r cu �aa� 8� irr�u BI�[� �VCRvT 9b�oi 4-�S rt- O/66 <br />1EMu1� uuL�ppPtss c r za ppryt <br />u+LuilkCt011DfSqNtP YuI�WPE55 Cilv LiV %Yy'[ <br />f[bCnLLCONl4�CION 4�M1ODCPE55 Ciry IJ RqIE Sl4EliCCNSE• <br />r'i� N 11 <br />YtOUN�CAILONfa�Lipn 41iUDp�65 GO� I'� P�q1iC 514EIXEN5[• <br />PtC�NuqCONIN�LIOn 4MVpDn�55 Ciry IC %NYIi 5111E1K1N5E• <br />o�scnm[ xon. u�o so��n[ <br />+si . u�cs a uou aewwibw: <br />etvenr vNa n.v a a� amom � ior+o� a� r <br />x VfI1101 I/lYN Of S mY1NLOf 10 W00 SR1 � f <br />�' dNmVINLOTqpA0D5MYi0W�YlNlDif/ <br />�ISP <br />suo <br />I _ TOTAL FEE 5 � <br />FOR OFFICE USE OI�LY: <br />�aOWq.ip1C� NGPS[lu[n 50CSE10�CX <br />ZO � ZCJ � S � <br />va� tv.r �7 mrm � v�urrtsrte <br />T�, �. �pJ LL^O� ;v�s y.rS <br />uH•:r��li4ilnlq�� �qU6MLLVM SICqBIaT <br />iC• mms . _ _ " <br />1Y1 <br />�'.IEi Yi�U <br />CITY OF EVEHETT <br />LOCALSALES <br />TA% COOE IS J105 <br />HEATING SYSTEM: f� GAS D ELECTRIC f� <br />roxuCt r[nwrurrorvq�.[ rq <br />I NERFOY CERTIFV TMAT 1 HAVE READ ANO E%AMINED THIS <br />APPLICATION AND KNOW THE SANE TO �E TRUE AND CORRECT ALl <br />PROVISIONS OF LAWS ANU 0liDINANCES GOVERNIYC TNIS TVPE OF <br />WORN WILL BE COMPLIED WITM WMETHEP SPECIFIFD MEREIN OR <br />NOT THE GRANTING OF A PEHMIT DOES NOT PRESU.'AE TO GIVE <br />AUThOFITY TO VIOLATE OR CANCEL TME PROVISION OF nNY <br />OTMEfl STRE OR LOCAL LAW REGULATWG CONSTflVCTION OR THE <br />PERFORMANCE OP CONSTNUCTION. THqT I AM AUTMORIZED OY TME <br />OWNER OF TMIS PROPERTY TO PERFORM TNE WORK FOR WMICM <br />APPLICATION IS MAUE AND I COMPLY WITH TNE °TATE <br />CONTRACTORS LAW IB U RCW AND 296.Y00 WqC. <br />x�G.� �'d��u:. G�zz�ct� <br />S�ce�mn[ ou � <br />urv ous�r.css iKni,i �✓� <br />emm�nr, <br />PWUBiIq <br />41CC11�11iUL <br />Appi1.CNNL VI.W CrvLCR <br />Olrrtn <br />SiqE BUM1�itfi SUM14nGE <br />vooic waa.s <br />TOTAL <br />fEE <br />�,� <br />