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APPLICATI� FOR CONSTRUC�N PERMIT / <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 •(425) 257-0810 <br />❑PROJECTiAD RE55: ❑ C%�QI/ 3Ie �/ i y�IP. � C,� MECHANICAL ❑ PLUMBING ❑ SION <br />41C���Y�[ll Cl1YI11\CIp�1 4��lAiAl1{$5 <br />1'1114PMIG C0�1111�f�e11 4��� �(y)qf55 <br />I <br />lO4�nKIPINCfUfw0�1e � _ — <br />nnoroar n vv <br />ir�"LIU�i_L <br />iu� .-- <br />7 � <br />?�,1 � <br />rnn� u. i u <br />IICfMS! • <br />S I�CENSE • <br />Fli[FNSf • <br />GAS ❑ ELECTRIC ❑ <br />uro r.prrt <br />, �������„l�j I HEREOV CEFTIFv 7NAT I HAVE REA� pND E%AMINED THIS <br />APPLICATION At1D IINOW TIIE SAME 10 OE TFUE I1ND CORPECT ��� <br />�p�� ,' / C� PPOVISIONS Of L�WS ANDOR�INANCES GOVERNING iN15 TY�'E OF <br />��L � B�p �J�l�_�8�� WORN Wq � pE COAIPLIEO WI7H WHETHEl7 SPECIFIED NEREM OP <br />NOT TN[ GRRNil4G OF q PERMIT WES NOT PPESVME 70 GNE <br />Bicr.a �� or AUTHORITY TO VIOIATE OR CAKCEL THE PflOVI510N OF RNV <br />OTRER STATE OR LOCAI LAW REGIILATINCa CONSTRUCiION OR THE <br />��k2� bF94. l4 Q�Q.( '�i' �Ef1FORMANCC OF CONSTRUCTION TMAT I �M AUTNORIZE� BY iME <br />� OWNER pF THIS Pf10PERtY TO PERFORM THE WORK fOR WHICH <br />_���_C�` ��� �� W APALICATION IS MADE AND I GOMGLV WITN TME ST4TE <br />i � C0�ITRACTORS lAY! IB 2] RCW AND 29fi 200 WnG <br />IO�NIlNfIFOI(1(M�6G f11fR�04FMVUP(11 <br />WPTER <br />�_ <br />FOR OFFICE USE ONLY: <br />IItM <br />SUD TOTAL S <br />PEFMIT S <br />�M1J1nINIL (��1( � <br />OiY BU9M SS l4N il Np <br />GAS <br />TYPE <br />N00p <br />NEA7E' <br />SfOVE <br />...,�.� ., ".� �. :.ny p�CR s�asne�ea riwnrcrer:uw�� <br />CJ �� <br />���.i.a•e io�•1,1�. v�cva5�q FEES <br />'—_ _n j rv ❑rts ❑mi .�nirvw. <br />VECd�II'Vi111tlV ±Y�!u`ly s�tEae�wm — �- <br />`L• l/d2erw's h�i�R� <br />�.����a. . v,,.�..�,. an•r.eiio.n e.ssr��r errnwru _�'�� <br />�;� Q'i � �_OZ _��"f'.4'Cr+'t%h•t ❑•�s �"� �mncwu n,wcrrtu <br />�����.�rf��•..unnran nj rw <br />/lC7-------- � �,S i1N�15 C:�LCi1c'� onKn <br />��:�.,u...i���in n��.m -` n <br />_�O_—____ �� �000 Y''L 3 `�u� nii.itwr.siinn�.nr.� <br />��nri��-�.�.� rursu•r.�n�,�nm C17YOFEVEHETT rnwcwn�.c � <br />�L LOCALSALES -� <br />V—� o.�t �a -v�•S�'� TA% CODE IS JI05 toT�l <br />!�/i '��inn\ H/i�.fS' �'.-�-[7V �..�Y//��/.W'\ <br />N <br />SUBTOTAL S <br />PERMIT T �— <br />70Tq�FEE S <br />Q�I�� nrcnm.�o <br />1U11T10N FEE <br />� 6 _—�— <br />,� �� 5� <br />'�� ��- �li.�' <br />--- G�/,i% <br />