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• APPLICATI� FOR CONSTRUC'ibN PERMIT� <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREE EVERETT, WA 98201 • 257-8810 <br />❑ DEMOLITION ❑ COMBINATON BUILDINO ❑ MECHANICAL ❑ PLUMBINO ❑ SIGN <br />ADORESS <br />........ ------- <br />u�vE <br />ARCN1�ECI DESU�ER WLWd1E55 GtY 20 RqNE p <br />aer�nuca,nucS^—F�`µ�� s'_Ft�' 3%/2rn`�2No /G=it/ E. .�?A �Jl�(LC(/I• /��`Z7�(.(Ay,C) <br />��y <br />MECN�MLK[ONIR lpi M�4MMIE55 tltY IP AqC 5��1ELICENSE• <br />wr <br />YY <br />SINK <br />0/D OD <br />inE55JELEPMprt MiNOEN <br />FOR OFFICE USE ONLY: �; ��( <br />rnor+rs[�u� nE�nscre� r <br />usezart �or•wc+ <br />fZ-Z <br />�EaH�ifspH �aowEumo <br />CCCUV�NLY 1qIX51CNE5 CCCV1'MIfIOM <br />6ROVP <br />V� <br />PoIESPNmRIERREOO PE�SON <br />iMEMARNPEd� RGSON <br />iYPE OF CONSI IRNIS ��PPMEO <br />1/�/.� ....�.���71 <br />6,oa0 ""`"'"�" <br />OVE6 ND <br />s¢¢ a xoon.i <br />2'13 S, F <br />B/�SE4EM! �� <br />❑VES QIIO <br />B1 CITY OF EVER'� <br />HEATING SYSTEM: ❑ (iAS ❑ ELECTRIC ❑ <br />cwr�crrEawr'uunaxE'a. ---._ltir isA_: <br />I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED TMIS <br />MPIICATION AND KNOW 7ME SAME TO BE TRUE AND CORRECL ILLL <br />PROVISIONS OF UW 5 AND ORDINANCES OOVERNINO 7HIS TYPE OF <br />WORK WILL BE COMPLIEO WITH YA7EMER SPECIFIEO HEREIN OH <br />NOT. 7NE �RANTINO OF A PERMR DOES NOT PRESUME TO ONE <br />AUTNORITV TO VIOLATE OR C�NCEI THE PROVISION OF ANY <br />OTMEF ST�TE OR LOCAL UW AE6UUTINO CONSTRUCTION OR 7HE <br />PERepplMNCE OF CONSTRUCTION. TH�T I AM RUTMORIZED BY iXE <br />OWNER OF THIS PROPEPTY TO PERFORM TXE WORN FOH WHICH <br />APPL�CATION IS MADE AND 1 COMPLV WITH THE STATE <br />CONTRACTORSUW1827RC AND298.P0 WAC. <br />� wre <br />GfYNI5f455LiC[NSE�q. <br />uecu�u�eu <br />PUMP <br />.w.u.�„�n3 ..�i �ll <br />FEES v�w�n <br />euaow 58 <br />RUWNO <br />MECN�MLIiI <br />/iWliqN�LPIANGY�EGK <br />OMER <br />St�tE BUII W!0 6URGIMOE <br />R10LG WO�� <br />TOTAL <br />