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APPLICATIQ 1 FOR CONSTRUCT(lN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDINGDEPARTMENT HEATINGSYSTEM: UGAS OOELECTRIC U _� <br />259-8810 <br />: 1 DEMOL�TION I� COMBINATIDN X BUILDING I I MECMANICAL ❑ PLUMBING I".i SIGN <br />ovmtn ��a+ooness nrv zm rrav[ <br />/�qnoN� ���.1J �9�� �4u ;,,G�{���-{'to3 333- ���o <br />IEN�N1 MML/.ODPE55 � y CItY I�P %IIX�E <br />A�CN��CCI OP OESiGNEP <br />CItY <br />G[NCMICONfRdCipR YAII�OIXlE53 CIfY SIV PIqNE S�AICLICENSE� <br />q� p,sv r l�f /77nc S.iP. SJati'-s G�r/u��a� `jnL� Y3llIY� OPFa//�/Q-/�r'^�'7 <br />M6n.VOCRLp11P�CIIffl MML�UM1f55 CIiY ZIC W10NE S1A!(LICENSE� <br />PWMOMGLIXitPI.CiOR N�R�DORE55 CiiY ZIP PNONE SUIEL1CCf4EI <br />[ppP�Cf 1'RiLP Oi �VCHM <br />a <br />��p00 00 <br />ntscmoevronn•ynsoqpee ioouee <br />I ILN/NC�1 /. 1 l J�''� <br />cfflSri.,' (/�nc.w✓a �- lTovc.�.— <br />u cu o[uamrroe ar rnorc�ec�ow on nrtecr� rvro coritsi <br />�a� 3` �a�35�L� a;� CC <br />_ //o � 7 — �a� /7 _ <br />1'��ICFL 1M I p N11M0[N <br />��_,��,� <br />E3ATMTUO <br />FLOOR <br />ROOF <br />FOp OFFICE USE ONLY: <br />t�R Of CONSt <br />SIIE OF &00 <br />OCCUPN1LYlOA� <br />n[�saH <br />pAfE <br />,��er <br />S ' <br />SiCE SEl&1CN <br />VAC.W t S�fE <br />fl yES f'. NO <br />im.r.Kr �aoi+n«ncin��n <br />4t4V <br />BASEYENI <br />I.-'�. VES !l NO <br />NEqNI UM11AlICN <br />CITY OF EVERETT <br />LOCIIL 511LES <br />TAX COUE IS 3105 <br />I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION PND FNOY. TME SFME TO BE TRUE AND CORRECi. ALL <br />PROVISIONS OF LAWS AN� ORDINANCES GOVERMING THIS TVFE OP <br />WORK WILL OE COMPlEiEO WITH IYHETHER SPECIFIE� MEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOE5 NOT PRESUME TO GIVE <br />AUTMOflITY 70 VIOLATE OR CANCEL THE PROVISION$ OF ANY <br />OTHER STATE OR LOCAL LAW REGULATMG CONSTHULTION OR THE <br />PERFOfiMANCE OF LONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PqOPf_RTV TO PEflFORM THE \VOFN FOR WNICH <br />APPLICATION IS MADfl AND I COMPLY WITN THE SiATE <br />CONTRRCTORS LAW 1827 RCW AND 2962�0 WAC <br />X �,�? °�� �aZ-s.�_ <br />.., <br />CLOTNES <br />RnNGEMOOD <br />STOVE <br />BWLDING <br />PIUMBiNG <br />M[CNRNICAI <br />AO�IiIONAI PUN CNEGN <br />OiBfR <br />STATE OUILDING SURCIIARGE <br />PUBtIC WORrcs <br />TOT�L <br />nmuvi rq <br />f� <br />jG <br />