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APPLICATIO* FOR CONSTRUCT�N PERMIT <br />CITV OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVEHETT, WA 98201 • 258-8l10 <br />❑ pEMOUTION ❑ COMBINATION ��UILON/O ❑ MECHANICAL ❑ PLUMBINO ❑ 810N <br />PNOJECT ADDRESS:TFE. i`�Iti:��.�� . - _ _ __ _ . <br />S��tF lCFNSE � <br />HEATINf: SVSTEY: L�IfiAS I?IELECTRIC ❑ <br />.� �.�1'T I� I re " 1 HEREBY CERTIFY TNAT 1 HAVE PE�D ANO EXIIMINED TMS <br />IYYE V� [{�'f AVPLICATION NID MNOW TME SAME TO BE TRUE AND CORRECT Al,L <br />rnpos o us[ or aaow'��� PqpNS10N5 OF UWS AND OROIWINCES GOVERMNO iM5 TYPE OF <br />WdM WILL BE COAIPLIED WITH WNETHER SPECIflED HENEM-(N� <br />ucro o vnaan � ix�aw • �twoconc5� NpT. THE OMNiIN(3 pF A PERMIT OOES NOi PREStNAE TO OIVE <br />�or saa ar - �UTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />ti � OT ST�TE OR LOG1L lAW REOIRATINO CONSTRUCTqN OR il1E <br />ERF01iMANCE OF CONSTRUGTION. THAT I MI �UT/pR1ZED BV TNE <br />ONMER OF THIS PPOVERiY TO PERFORM 1NE WORK FOR WI/ICfI <br />� . �PPLICATION IS M�DE AND I COMPLY WITH THE STATE <br />..l� ..�„ ,,.�a CONTW CTORS 41W 1E.21 RCW AND 2B6.Y00 W�C. <br />COMSIRIIL1qM lOM1 ILMf R. <br />FOR OFFICE USE ONLY: <br />n.w <br />IV��Nfw vWAM1Y�k µ�n ��^ <br />�- u ❑�ES OW �� 7 2�li ZiO <br />MFKVIi4 � UMOM'O�ON[llM6 9tEdllCdfl <br />(? � � O 1 h11u0M <br />OCMM{� NJd(ICMS OLCIf.1NfRHU 115E H� VFCNu4C.4 <br />� � j✓ ❑vF5 �w0 <br />EflPWD nfc:IX1 �OD�INYYIM1/J16rtC� <br />ES oRoiaAv�C o,�<w <br />iqEHAPYRfOO AFAiO� <br />C00( DRp!^�AN�E. su�cewo�nvnc�ur� <br />nvEacarsr n•Ms�Pr++ovco CRYOFEYERETT MaK�� <br />L- I Il R �.,. L, -o _ 4 a T L�e�ooe is ai i tOTAI <br />