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,�4PPLICATION F� <br />�.� CONSiRUCT10 <br />everett PERMIT <br />DEPC OF COMMUNITY DEVEIOPMENT SERVIC::S <br />CItY HAIL 259�E7�5 <br />EVERETT. WA9e�1 ❑COM�INATION ❑ �UILDING ❑MECHANICAL ❑�LUM�ING PnEREMIT N . <br />rnr _ t <br />0 <br />e <br />rrt� ZV �NOHE ........_ <br />M�R �UDRl55 <br />MUNoIYG (ON1R�CtW _ <br />��ASSOf W011R <br />❑�EW ❑ADDITION ❑AITERATION ❑REPAIR ❑DEMOLITION ❑FENCE SIGN GARAG <br />'�N�IIONOf W(s�k � <br />.a` <br />�uceie� wo�c <br />Qfv <br />norosto us� o� ewi ie� <br />iee.i o�scamior. o/nrion <br />ioi � eiaa 1 <br />� L (/ ��..- — <br />io�•oo��ss <br />G v'-o <br />� <br />fWM�IAG <br />�n.cN <br />lOT ARF� � � V�CANT SliF <br />� �YES �+O <br />OCCUPANC� GROUo NO. Oi DW1E❑ <br />�� � ` <br />' NO OF STMIES M�% a=10 <br />"�� �+ �10 �' Ori <br />�/MOV�If �� <br />1 ENVIIIONMfMTAI CMECR liST <br />7. BUILD�NG OlANS <br />7 {IRE MYORANT <br />� F10.E PIIOTECTIOM SYSTFM <br />5 GRAUINLIf%C�VA110NLClFMIINGLRUBRING <br />6 OR��nAGF <br />7 fNVIRONMFNi�I IMMCT ST�TEMtNT <br />! HF�LTHDISTIIICT <br />MPl�UT10NACC EY /UNSCMECKFOOY � <br />v �- <br />91 79 <br />O�iF <br />I fOR Issunm <br />L•C.• <br />I HEREBY CERTIFY THAT I M/.VE READ AND EXAMINED TMIS AP• <br />pLICATION AND KNOW TME i/.ME TO BE ?RUE A��D CORRECT ALL <br />OFOWORK Wll�l BE COMP E D WIiN WHETMOER SPECIFIED MEIIEPN <br />OR NOT. ?HE GRANTING OF A PERMIT DOES NOT PRESUME i0 <br />ANY O HER�ST1ATE OR L'OCAI L W0.REGU A11NG ONS RIUCTION <br />OR THE PERFORMANCE OF CONSiRUCTION. <br />SIGNATUIIF �CONT6�CTOR dl AUTMORIZfD �GINT w D�If <br />�y-�- <br />MECM�NICAI <br />I FFf <br />���o� 2 � <br />BUIIDINL f <br />PWMBING <br />MlCHANIUL <br />O1HE� <br />uec. <br />PfMALTY SFC 7�NU <br />tO7Al � <br />rE�Mli VMID��ION <br />WHFN PIIOPFRLr VALIDATEOI�N TM�S SPACFI TH15�� 6�/ G�MI�,n Ks y����� <br />I]Z/6y v5� P�2nt I i %b � <br />