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APPLICATI��OR CONSTRUC� <br />CITY OF EVERE7T • BUILDING �IVISION <br />3200 CEDAR STREET • EVEREff, WA 98201 •(425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />PERMIT� <br />��rs <br />❑ PLUMBING � SIGN <br />�na«imronnssicncn vui.00wFss nn --7�� � n�p.,r —' <br />Siw, MC�✓MiwJ a.✓ �v„-�- tu�_F�azo ?7Y-/iCf� �'i��nn�9aWMB <br />cF�+[nu cown�arn u�n enun[ss �nr nr rnr��r �t..n nttvsr . <br />uFCHIXiC4CO'lln�f,�V� 4uL�fRMF55 C�tv )il• PUOM1f [u�FUCfu$F• <br />1'1lIM0MGf.ON1R1f,1M M�I�/.pM[SS [IfY jIP �INJ��( �I�IlIICEMiF• <br />� <br />io� oioc+ <br />�y� �!.i �i S OS � <br />IO�NIfNfIf11.NN)n[55 ![l(M1IONE�IUNIIEII <br />TYPE OF <br />LAVATORV <br />FOR OFFICE USE ONLY: <br />rnouivrner� nr.nsnn.ca siossr�e�c. <br />115[lOyS./ 1 <br />�� � <br />11FIG��IIIVII��NY <br />fi�E <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />r.w+uc* iv nscr+�r�n rv�ovr uo <br />I HEREDY CERTIFY TNAT I MAVE READ AND EXAMINEO THIS <br />APPLICA710N AN� NNOW TIIE SAIAE TO �E TRl1E AND CORRELT ALL <br />PROVISIONS OF LAN'S qND ORpINANCES GOVERNING THIS TYPE OF <br />WORN Wq� BE COMPLIED WITM WHETNER SPEGFIED MEREIN OR <br />NOT. TIIE GRRNTING OF A PERMIT DOES NOT PRESVME TO GIVE <br />AUTHOFITV TO VIOIATE OR CANCEL THE PROVISION OF ANY <br />OTIIER STATE OR LOCAL LAW qEGULATING CONSTRUCTION OR TME <br />PEPFORMANCE OF CONSTRUGTION TMAT I NM AUTHOFRL� OV TME <br />OWNER OP TMIS PROPERiV TO PERFORM TME WORK FpR WNICH <br />APPVLATION IS MADE FNO I COMPLY WITM THE STATE <br />CONTRACTORS l AW i8 21 RCW AND 29fi 200 WAC <br />X Q... .2 �-�.Q..--- /�/31 s� <br />E•fN�h� ( U41 <br />COY RIISnRSSI�fFNSC HO <br />TYPE <br />im�a[e v�uw�suE FEES <br />❑YES ❑ AO Nl����Nf. <br />p0 b pw(lliNG 5�lE O� PI�Ga� <br />II4�IG C11149Y i <br />U'CIIMNIlU10 IB�SfNIMI Nf(�.M�4�1'�I <br />❑�FS ❑ N� <br />�� ��ry� �D�III;IN�I (Y M L��lCR <br />ov�[n <br />arT`nv <br />su�i nunumc, simn�m:r <br />rtnMs��rl. �or CITYOF =VEHETT nwi�cw»u..c —.�. <br />" IOCALSALES <br />u.,F ,� � t, S�S � TAX CO�E IS 3705 TOTaL <br />SUBTOTAL S <br />PERMIT S <br />70TA�FEE S <br />rFt /fJ nrrnmuo <br />d`�r.6 <br />VALURTION FEE <br />— �__ <br />/�00 ;�� <br />__ ..._ _ _ _ ... ���. <br />