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APPLICATIOR FOR CONSTRUCT�N PERMIT <br />CIN OF EVEREiI' • BUILDING DNISION � <br />3200 CEDAR STREET • EVERFTT, WA 98201 •(425) 257•8810 �����' <br />O DEMOLITION ❑ COMBINATION ❑ BUILlYNG ❑ MECHANICAL ❑ PLUMBINfi ❑ SI6N <br />1EN�Y1 Y4lLCpRE55 G�Y Iiv nnw2 <br />Af1LHi[Ct W. pEyf.NER MM b0iE55 CItY ll� P�KMF <br />GFNfMIf.ONIMGi0f1 MYlA0dIE55 C11Y )�P MqMF 54tEUC[NSE• <br />MF.CNI.NIGLCOv}F�LfOP MMI�bORE55 Gtt IIP V�qNE i1nFPCEHSE� <br />V:UUBMGCpNIH�f.1pP M4t�f55 Cltt IIP VXONE SUIEIICENSE� <br />io� aiau <br />COVSIHIIGi1pI 10�N IENpEP, �pp1E55, <br />vwweu <br />FOR OFFICE USE ONLY: <br />IPONfS�ifl6M PHPSFIO�LR <br />IISfSONF IOI�f1EA <br />IIfIG���11MIt.��IOY NOOfUWElLINO <br />IIYIIG <br />a:car�acr rno�sma�es acu�eH�m�o <br />f�11p11C <br />flfl[SPPIAFlL11PE0'� nFA[ON <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />1 HEREBV CERTIFY THAT I HFVE REAO AND E%AMINED THIS <br />�PPIICATION AND KNOVt TNE SAME TO BE TRUE ANO CORRECT ALL <br />PROVISIONS OF tAWS AND ORDINANLES GOVERNING THIS TVPE OF <br />WORK WILL BE CAMPLIED WITH WHETHER SPECIFIEO HEREIN OR <br />NOT. THE 6RAMING OF A PERMIT OOES NOT PRESUYE TO �IVE <br />AUTHORI'Y TO VIOLATE OR CANCEL THE PPOVISION OF ANY <br />OTHER STATE OR IOCAL LAW RE�UUTiN(3 CONSTRUCiION OR THE <br />PEPFORMANLE OF CONSTRUCTION. PQT I AM �UiHpRIZED BY THE <br />OWNER OP THIS PPOPERTY TO PERFOAM THF WORI( iOR WHICM <br />APPLIC�TION IS MADE AND I CUMPLV WITH THE STATE <br />CANlRRC� U�B 2� RGW AND Y96.200 WA� �'�� <br />SifN�iWE � ��rt <br />GiY&ISu.F55lKfNSE1p <br />LOF5f�81{K r��Nc��E <br />G <br />V�.C/�H� S��C <br />OvFS ❑ xO q���q� <br />OrfS OHO <br />CRY OF EVERETT <br />LOCALSALES <br />TAX COOE IS 3105 <br />nvunwo <br />MFf.11�N�G�I <br />�Dp�ION/.I, ry I.N CIIlCK <br />OI11fP <br />G111f RINIU�Nf SII�L�4MF <br />rnnur.wonns <br />TO7�L <br />nrcnrrxo <br />