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APPLICATI� FOR CONSTRUC�N PERMIT <br />CITY OF EVEHETT • BUILDING DIVISION � <br />3:00 CEDAR STREET • EVERETT. WA 98201 •(425) 257•BB70 <br />�i <br />❑ DEMOlIT10N O COMBINATION /�❑ SUILDIN6 ❑ MECHANICAL C-I�PLUMISING O EION <br />PROJECT ADDRESS: 2O�_U h►� V�Q <br />J�e h�. Or.Lw � l� a, 17oX �0�/3 Wf4L%,1/-�� !.-�.9, Sr27s� <br />�_��f% oN„fS' �ve�e't� .. . �.2,5' � dGC / <br />�M4C4In 4uINfInf55 [�Ir pr rrqy� <br />4FCM1w:4C[WIIUf,IUP 4��1�lIdR55 O1V li�' Mb4f <I��Fl6(NSE� <br />1'111401MGCON9UCIM 4�K�qY1[SS Ptv 1�V 1'wJ4f SOlfllC[45f• <br />4 �e ��, l rh� ,►. � p�� �r,�,7 v2s'� y7o � <br />cann. rr.c� wo�+ HEATING SVSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />M SLMi11F M]nF �Y� Sd1�P1 VOJtI.GF MVOIVf 0 C W��Ll rl nSON �M11`M4! Np <br />"� �`��'r� I HI:flEBY CFRTIFY THAT 1 NAVE RE�D �ND E%AMINED TNIS <br />•PPUCATIJN ANO KNOW TNE S�ME TO BE TRUE �ND CORREGT �LL <br />���a�osro vse or �nnpen FROVISION$ OF L�WS AND ORDIN�NCES GOVERNING TI/I$ TYPE O: <br />WORK VnIL BE COMPLIED WI7H WHETHER SPEGFIE� HER[IN OR <br />ircu�scmrnwar+arenrvisrovmnuowaun¢Htwocontsi NOT THE GA�NTiNG OF � PERMIT DpES NOT PRESUME TO GIVE <br />�a� µaR p AUTHORITV TO VIOIATE OR CANCEL THE PROVISION OF �NY <br />0T11EN STATE OH LOC/�L UW PECVLATING CONSTRUCTION OR THE <br />PERFORMANCE Of CONSTRUCTION TMAT I �M AUTMORIIEO BY tME <br />r OWNER OF TNIS PRO"ERTY TO PERFORM THE WORK FOR WNICH <br />___� 7 Z S' �O DU�v/� 006 J APPUCATION I$ MADE AND I COMPLY WITM TNE ST�TE <br />r•ucn u� i o ruuwn GONTR�CTORS UW 19 2� RLW RND 29fi 200 WAC <br />cov�imKnnwia.r.ir�nHN+ncss.mtr.�or[�v-.n K,�M;�.µ�� <br />r u.it <br />cnr eu4rrtcs irci Hv .�n <br />WATERLLOSET <br />DISP <br />AIR SVSTEM$ <br />ORYERS <br />GAS RANGE <br />� TOTRL �EE f � � � <br />FOR OFFICE USE ONLY: <br />�nr�H�vrn�c. nr.ncrie.c� vastre�c� n�wn�EcxHuwrn rfr <br />ust torr im e�u v�cw� snI FEES <br />❑rE5 ❑ �+U q���Mw. <br />11FIOIIIIIVII�IIOY NOf}l1Wf1111Q $11[dlIOG�II <br />o�ns rioun�m <br />accwn��r wn.�„o�s atur�u�irnu e�ux�:t otuuewu __'. _ <br />anooe <br />❑n5 O wo —' <br />nnesrnruicen[au-- m+w.1 �owun,ur�.unxc+ <br />m�x� <br />rw[eienunwo �- irt+snv <br />5�u1 n�n�o�+n5uncnu�Cf <br />�rncxcp�a rinwg�rrnrnrnn. CI7VOFEVERETT �+�mr.xonvs <br />LOLALSALES — - - <br />,,.�� TA% CODE IS J1� TOTAL <br />- r <br />PERMIT S <br />