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APPLICATI�1 FOR CONSTRUC'+ON PERNlIT�� <br />CITY OF EVERETT •'cUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 257�8870 <br />!_i DEtdCLITION :�. COh1BINATIQN ❑ BUILDING i] MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTAD�RESS / - / /J S—/—OZ � <br />J'¢ a"%�('2 .� e�l,o� qft�v f`i�i� C o v o y-O / j <br />u.ui �eco��ss cnr r.r v aE <br />J� '�1i7't�:.S Ir�rj i�,it.,� i�i�� f-�� U�� /�'�c� tf�� ��� j����� � <br />oiv�� n inoo��tss a� ne m�o.+e <br />li i - ��-..� Zr c�i'ns S ' ` ' ` �, � � � , � , <br />,�i.i.�I��:,CpNIflACiOA M�ILNIDFf55 CIIY � IIV PNOq[ Si/.iEUCEN$E� <br />i �1���� <br />i-�iv...¢'n�coNin6*on uEv�poPEEs crtr Iiv N�ONE 51e1EutFN;[. <br />i_,:inU.vGC0111PLLTOf1 IAAiI/.0011E55 f,irv Z�D pXONE Si�IEIICENSE• <br />�csc:��. •onHer�o�[ <br />�f�Cw K <br />l��'� 1��, <br />�� i <br />��� <br />w� � e�wn <br />S�U�[o_ n �' <br />wvav[a <br />�� <br />� ! v,. ' � <br />:���i_r ��:� <br />. <br />�.•.. "�/Pr '� � <br />IO�N Lf 110E11. AD:)�LSi.ICI[�1�011E INM6EN <br />�FINkIYG FOUNTAIN <br />- F�oo� o�.�ua <br />�4CNPLOYJPREVEN' <br />— _^,INH �SEfiVICE — OF <br />5 <br />HEATING SYSTEM: f�l GAS �EIECTRIC ❑ _ <br />7dJ �.�47' /"l Yi <br />I HERE�Y CCI`TIfV TIIAT I IIAVE READ AND E%ACIWED TIIIS <br />FPPLICATION AND KNOY/ THE SAI.tE TO ElE TRUE ANp COPPECT AI L <br />PROVISIONS OF LAWS AND ORDINANGES GOVERNING TMIS TYP[ OF <br />WOFK WILL �E COIdFLIEO WITM WMETHER SP[CIFlEU HEfiEIM1 OR <br />NOT. TME GRANTING OF A r ER1dIT DOES NOf PR�SUME TO GIV[ <br />AUTHORITY TO VIOLATE OR CFNGLL TIIE PHOVISIOC OF ANP <br />OTHER STATE OR LOCFL LALN flEGULAiING CONSTRJCTION OR THE <br />PERFOR!dANCE OF CONSTRUGTION. THFT I At.1 AUTHORIZED �Y THE <br />OWNEFI OF THIS PROPERTY TO PERFORM THE PoOdK FOR VINICH <br />�PPLIC�TION IS 1dq0E AND I COLIPLY WI74 THE STATE <br />CONTRFCtOfiS LAY! 10.21 RCW AN� 29G200 WAC. <br />/ <br />x �L' -�"/� _ - <br />sicrv � � oere — <br />CIIY OUSelG55 LCCpSL NO <br />RANGEtIDOD <br />WATER HEATE <br />W000 STOVE <br />FOR OFFICE USE ONLY: <br />��� —�1+�AfiSCIfI�CF 61'JESELBACN PLANGIEGI(INMOC41 <br />�.�'��1; �O � S cono9-oi3 <br />i r i� �'���+�� v�.[�vrs�F FEES <br />��� �^ �j/Q7y fL nves n No nuaoivc <br />. ..-I;n r-� iio°ro�.vanv� s¢rormeeri. ) <br />.l 2S�' �(•.1�: Sf. Pluu6�NG <br />. .. %�IpuQS CCGV�4'�IIUnU OA.SE LI�I� IAEGNVlICK <br />�_. � '� ` b'T[5 O NO — <br />. - . , i.'OU PEPSON �OOIIqNRPIM'CNECN <br />1 <br />' m amrn <br />� � . .��un n �E�SOrv � <br />__L -��.� _. <br />ilq E UVIl01NG SUIILIIMGE <br />rvu�serriy,,inm CITYOPEVERETT ruo�,�cv,onns <br />� LOCALSALF.S <br />�.,, ��'?��� Tq%COOE15�105 TOTAL <br />SUDTOTAL 5 <br />PERMIT S <br />TOTAL FEE S <br />�/_'' . �i <br />rce -. eccnorno <br />VALUATION FEE <br />_—�—_ <br />!�D r i <br />���111 i �) � �' � ' <br />�1a�_ <br />I <br />I � `. <br />