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APPLICATI� FOR CONSTRUC�N PERMIT <br />CITV OF EVERETT • BUIIDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f� DEMOLITION f� COMBINATION fl BUILDIN6 - MECHIINIC:RL � 1 PLUMBING I1 SIGN <br />PROJECT ADDRESS .�Q � � � � ^ ` � �' � � 7 , <br />_ Q Q �,-.� <br />M1)4pNGCON1R�f.fp1 N�II/�IMME55 Q�Y }IP f�lbYE SI�ICLILiNSt.• <br />coninec� rn�cr ar n��y� 2�C o., HEATING SYSTEM: �GAS f 1 ELECTRIC I 1 <br />Q' ) <br />ucscniec won� �ro sounaE rooiwE mvavco cavinc� rrnsa+�rm r��orR rro <br />L���N ,��,.;�- <br />-� IA1 <br />Pip105t0 UfC M Aunpep <br />I EG�L OESCRIf'1Ip10I 1'110M <br />\Oi BLIXM <br />�uicciuRiomn.�nrn � <br />[ <br />ca�s�micnon�o�Nic�mrn <br />PIUMBINO <br />NO. TYPE f <br />WATER CLOSE <br />BATNTUB <br />SINK <br />FOR OFFICE USE ONLY: <br />rm»nsFtn+cK nrencrtwcx <br />osr)ov[ im�nr+ <br />��Eima uunenori vo a nwuuHc <br />IMi�c <br />IXCIIPANCY Iq(MS11W11i ULCV1MNIt041 <br />nnt <br />FEE E <br />s�x sr�n.c. <br />wcrv� v�r <br />nrcv r xa <br />�� C��-�I-tGG <br />I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED iH15 <br />APPUCATION AND NNOW THE SAME TO BE TFUE AND CORRECT ALL <br />PROVISIONS OP LAWS ANO OROINANCES GOVERNING THIS TVPE OF <br />WORK WIIL DE COMPLIED WITH WHETHEN SPECIFIED HEREIN OR <br />NOT. iHE GRANTING OF A VERMIT DOES NOT PRESUME TO GIVE <br />AUTMORITY TO VIOLATE OR CANCEL THE PROVISION OF RNV <br />OTHER STATE ON LOCAL lAW REGULATINO COYSTRUCTION OR THE <br />PERFORMANCE OF CONSTROCTION. THAT I �M AUTMORIZED BV THE <br />OWNER OF TMIS PROPERTV TO PEFFORM THE WORK FOR WHICM <br />APPLICATION IS MADE� COMPLV WITH THE STATE <br />CONTRACTO . 7 R 296200 WAC. <br />5`MN�111 ��� � <br />LIIY flll VN�SS 11CtN51: NU <br />Sv57EM5—BTU. M E.A. <br />IS—BT.U. M <br />RANGE <br />r.vanrn I ru <br />uunn�vr. <br />SII[ C� Pll%191 <br />1'111MP�NO <br />P�4MEN1 NfC1UMGl <br />IIKS I�NO <br />♦f1qI1�YI.1 R�NdifCR <br />nnrtn <br />�uic n�morvr. sarK:�unr.s <br />CITY OF EVERETT ronur, won.s <br />LOCALSALES <br />TAX COUE IS 3105 TOTAL <br />TOTAL FEE <br />