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APPLICATI� FOR CONSTRUCT�ON PERMIT <br />CITY OF E`: _RETT • BUILDING DIVISION � <br />3200 CEDAR STREET � EVFRETT, WA 98201 •(425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ,�l MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTAUDRESS: � �E_.'�'yI (G-c'�'1� h��.11.L WYjy <br />5� � f�li �4 <br />lEM1Ni M111 �IIMF55 C11V jIV VIIOMF <br />♦I16bTfCfO��ELW�FP M111�UOaE55 [nr nr rwwc <br />cnr IGi� s n.{f�ir� NEu7Kw�c surtucrnsF. <br />�iL. E V�tcR �t87o1 EVE�GSS Q�.'iOT <br />C111MB:HGCONWIf.iM MutRSMF55 <Ib jIP PNONi SIAIEIICEHSF• <br />� �(li/"t�s� <br />S <br />im eiacx or <br />i[l[[MOr'E MIW�F�� <br />E <br />HEATING SYSTEM: T�GAS ❑ ELECTRIC ❑ _ <br />LGI11Ct vlRSON �Nfl M4Mi NO <br />'R.,ss K"..2au. 92s12sz-3u4 <br />I HEREOV CERTIFY THAT I HAVE REAO AND E%AAAINEO THIS <br />APPLICATION AND I(NOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIDNS OF LAWS aN0 OROINANCES GOVEPNING THIS TVPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER SPECIFIEO HEREM OR <br />NOT. TNE GRANTING OF q PERMIi OOES NOi PRESUME TO GIVE <br />AUTNORITV TO VIOLATE Ofl CANCEL THE PROVISION OF ANY <br />OTIIEF STATE OR LOCpL LAW PEGULATING CONSTqUCT10N OR THE <br />PERFORMANCE OF CONSTRUCTION. TMAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PqOPERTY TO PERFORM THE WOHK FOR WHICH <br />APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br />GONTRACTORS lAW 1B 2] PCW AND 296.200 WAC. <br />x��L la%za%98 <br />'!GNAtUi1E 0�1 <br />LrtY9OVN[SSUL[NSCNO <br />MEAT PUMP <br />INSERT <br />GAS FANGE <br />I _�_ TOTAL FEE E I I I <br />FOq OFFICE USE ONLY: <br />rnnurarpnrv-- nr�ncnp�c� smt5frP4n ri�Ht��[yer�y,yxf /� <br />C(%U % V <br />i�n�ovr �oinau v�cewsn[ FEES <br />. ❑r[s ❑ uu xinmiva <br />I�fIG�1�1�4i1��r{t� Iq(y�IWFlII� 511FO�BLO(i�tl � <br />IMil� <br />llf:llR`�4' �� i �. oi <br />f.110v�' <br />Irl�[ ��`��'•.nllH{:L7[1 <br />f.f�1 il���•.� uL': C <br />�'II!MP�.4fr ... <br />11i(4F�1 Ml1:1�1.\�1�.�1 <br />❑�[5 ❑ NA <br />� 4D0�11(IN�11'I�NI��ICK <br />� UInf11 <br />Gl�lf fl11il�Mt:5�111C1��f1[:( <br />p7YOFEVEHE7T ���nnr.wn�uc <br />LOCALSALES -- <br />TAX CODE IS 3105 7o7A1 <br />SUB 707AL S _�� <br />PERMIT 5 <br />TOTALFEE S <br />rfr narrr�xo <br />VALUIITION FEE <br />___ _�_ <br />_�� <br />