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APPLICATI�MI FOR CONS�TRUC�ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAq STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COCMBINATION � BUILDING t�❑ M/ECHANICAL ❑ PLUAIBING ❑ SIGN <br />PROJECT ADORESS: ,"rj J�� GG� N i�i A I�n.i! p(i// <br />owHtn uen�opncss nn rm r�wHc <br />1-lnr��rtl C�r�v 550.�. wN,s,l/Any� k � E've �h 99'a•o� �537 a�/9 <br />f . 4lLpp11E55 Ub IIP MqNE <br />MGMqpipqp(SIGN[O Y1ilqIp11E55 �Iry IIO P�qNE <br />um <br />uui <br />� <br />1'IUMBYMCpllfl/.C�M M�ilACd1(55 CI�Y I�� PIqHE SUIEl10EN5E• <br />roouot wvav�o <br />Cfnin�r _ <br />mr <br />�we[n <br />URINRL <br />DRINKING FOUNTAIN <br />FLODR DR�IN <br />BACKFLOW PREVENTERS <br />SINN (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTAIFEE <br />FOR OFFICE USE ONLY: <br />rnpit scrp�c � nr�n sti� � si <br />� <br />��E:�� _� �o�.�E, - �, <br />��tic��ruwr�trox ry � w orowc�una sii[a <br />1J�1 uMili <br />! (./ <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />covuc� rcnwH uo nro� rn <br />�Gtn��� � 'i�/�'lr <br />I NEREBV CERTIFY fHAT I H�VE READ qI�D E%AMINEO THIS <br />APPLICATION �ND KNOW THE S�ME TO BE TRUE AND CORRECT ��L <br />PROVISIONS OF LAWS AND ORDINANCF� GOVERNING THIS TYPE OF <br />WORN N'IlL OE COMPLIED WITH WHETNER SPECIFIED MEREIN OR <br />NOT. THE 6RANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIO_ATE OR CANCEL THE PflOVI510N OF ANV <br />OTHER STATE OR LOCILL LAW REODUTINO CONSTRUCTION Ofl TME <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTNpqIZED BY THE <br />OIVNER OF iHl� PROPERTV TO PERFORM THE WORK FOR WHICH <br />APf•�ICATION IS MAOE AND I COMPI,Y WITM TME STATE <br />CON(RRCTORS lAW 18.27 RCW AND 296700 WAC. <br />x ��� � � �.�� l�� <br />SM✓I��UnE � OAl[ / ' <br />CI IY BUSINE$$ l ICI MSC NO <br />ortc.ruuarn <br />❑rts o rro � ouiom� <br />25 S F. ^""°" � <br />r runs�rnrs accuru��io�n e�scu[n� � utouµui <br />� ❑res B"I+o <br />xcnuov nrnsa+ •��roMunu�c�rtc� <br />Op�E� <br />NEO'D RE��OM <br />$IqF UNlLiN651N1L4�ME <br />�+sr neHserrnovEoer CRYOPEVEflETT M�e:ir.nd�+s <br />E � L LOCALSALES — <br />'� c•� /X... TA%CODEISJ105 70TAL <br />ffF <br />GO <br />1 <br />�J <br />I/ 'C /� <br />_1 <br />.7. J1C7� <br />