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APPLICATIO� FOi1 CONSTRUCT�1�! PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 •(425) 257•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILOING ❑ MECHANICAL ❑ PLUMBING IGN <br />PROJECT ADDRESS: S� Z-f/&((&?j M�}« <✓�7 �3 �� i�d''�"7% �Q �!BQp� , <br />tZa�:nt+h ro it f�^' fUC-!'G/1-Ptotc r. S�C�1F17 .✓q �% 2Od S'zS =i13 �jCoo _ <br />��Eq Nul�Ld�E55 Ptt S�� FnOHC <br />.. .. .__ ��-,..,.,. tt-t[ .�✓i r iNsu�rio/%. ✓.f- Y/2oo �ftJ'—aQ�j_ 3�97 <br />rN7r�i1'�" <br />PIUNBMGCONIP�f.�CO N��IEpME55 Cliv jiP ��(1N( S���FIICFNSF• <br />coNrn+cmn�cear��, HEATING SYSTEM: ❑ GAS O ELECTRIC ❑ <br />o[scnioovnnH� nmu�ur�owm[mvrnvco crn+��crnrnso��unrH�rvo <br />._... . . . __" . .�,...,...� ,rniir.fhcw. ?!ln7t Khn h�Ll-'9�/-d'�2? <br />KOCC-w94/ �N 7/f� I7GCc� wgCL <br />r�+orasro �sE or e�mwvc: <br />iceu oEscnirriw or rmorenn �nax+i etiow ou •n.cM rwo coAcs� <br />im o�oa or <br />r�wcc�u.�o ruuncn n <br />�J��f j—��� <br />i'iwcinifilnu101N1[NOFP.MM1ESf tCLF1'NOMENUVNEfI <br />PERMIT E <br />TOTALFEE S <br />FOR OFPICE USE ONLY: <br />rnnutvm�rx nr�amnr.r.v <br />V".F IOVl� 1 10� �nF♦ <br />1�FIf1111�V11/.�iU4 Ili'b l�Mfl11N4 SIIF <br />GCCIII'I.1':• 4 i�.. o�> IH�CIin11111I1�11 <br />[IPESMI:'IFIEMPE40 ������ <br />riaainel•eivo _'_ nn�or <br />�rr� rr �o•��� nnes.�rnnr <br />nut ///� <br />1 HEREBY CERTIFY THqT I HnVE AEAD AND E%PMINED THIS <br />AP°LICATION AND NNOW TME SAME TO DE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEflNING THI$ TYPE OF <br />WOAK W1� L 6E COMPLIED Y�ITH WHETHER SPECIFIEO HEHEIN OR <br />NGT. THE GAANTING OF A PEPMIT UOE$ NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTNER STATE OR LOCAL LAW REfULATING CONSTflUCTION OR THE <br />PEPFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED OY TNE <br />OWNER OF THIS PFOPERTY TO PERFORM TME WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS 102] PCW AND 296200 WAC <br />� <br />x_���it— �/Ls'U� <br />=:CiIAIUN! f)��C <br />blv B�5N6512Fn5[ vp <br />f f <br />FEE S <br />'= oo� �...7a.3/ <br />1C�r1� �IIC ___ <br />f•rE5 ❑ rvU qnuPnrc. <br />BlOG41 — -_""— —. _ —_ <br />qpuP�.p. . ._...__. -..- <br />�SI4H� 4H �����Cn <br />❑YFS ❑ Y7 <br />lpqli(1Y�� fl �N' '�� i • <br />urfn � <br />.�ui nu�m...c•nnr�un:,. � <br />CI1Y OF EVEHETT �����'�. ^ �'�- _ — <br />LOCALSALES --�---- ��Y� <br />TA% CO�E IS 7105 TaTAL I' <br />NO <br />FEE <br />Y. .:J� <br />r ;OCa <br />