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APRLICATIO�FOR CONSTRUCTI�N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVEREIT; WA 98201 •(425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:500 SE Evere[[ Mall Wuy <br />R4.4111eon Prooert�es 607 SE Evere[[ Mal] Wnv li4 Eve�e[[ M'A 98208 353-8400 <br />OwMfn 4n�elqnF.55 Cin Im v�qNt <br />Lltv <br />•11CIIlilLIO(IpE.:C11�11 MAi1�Of111E55 CItY li� �IK1HF <br />G(NCMICONIMCI(XI Mut�00f1E55 CIIV bP ��q4E S4IIIIC[NSE• <br />Gaffney Cons[. 1715 100th PI SE Everet[ 98208 338-2114 <br />MFC1UNiCAI f.0YtR1C10P MUL�f.b��k55 Lltt lif PIqM1f SG�f I�CFN[E � <br />PI11VBiNGCON1P�Clp1 4�Il�IXME55 CII� IIV VNONF SIA�EULENSF� <br />io� oiocK <br />WATERCLOSET <br />SINN <br />FOR OFFICE USE ONLY: <br />rnnurann�;.x npen� <br />II:E lO4� <br />��EIG��tI�Vlf.�t10N <br />occure�.cr e., o�s�rut� <br />mvIXVED <br />IOI�nEA <br />HO P UW(IIIW <br />Nil� <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />I HEHEOY CEPTIFY Tk1AT I HAVE READ AND E%AMINEO TMIS <br />APPIICATION AND NNOW THE SAML TO �E TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND OPUINANCES GOVERNING TIiIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOL TME GRANTING OP A PERMIT DOES NO7 PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PHOVISION OF ANY <br />OTHER STATE OR IOCAL LAW REGULAiING CONSTFUGTION OR THE <br />PERFORMANCE OF GONSTFULTION. TNAT I AM AUTMORRED �Y THE <br />OWNER OF TNIS PROPEFTY TO PERFORM THE WORN FOR WHICM <br />APPLILATION �S MADE AND 1 COMPLY WITH TNE STATE <br />CO4I�ACTORS LAW IB 27 RCW AN� 296200 WAC. <br />x-�-�� �� <br />scN� on[ uu[ <br />Cliv 6114NESS l�CE NSC NO <br />5 , PERMIT S <br />`EE E 7 j�7� TOTA� FEE S <br />sbcsFie+ca r��voi[cnn�yw�ly/ «r nrr�iriuo <br />sY <br />v�U�nscF FEES VALUAiION FEE r_ <br />❑YES � NU flUIMNC <br />S�tF OI HLDG4� <br />PI V VPiNG <br />B�it4EN1 4..1:11 WiC�I � <br />❑r�s ❑wn ' '-- __ <br />•oo�unu.i. n.w o�rc. . <br />CRY OF EVERET7 <br />LOCALSALES <br />TA% CODE IS 3105 <br />O�i�E�� <br />!'�I�II flllilUW(:5�111C1411C! <br />runi ir. wnnwc <br />TOTAL <br />