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T TO BE COMPLETED IN BLACK INK—PLEASE PRINT • •`••,•" ,� <br />BUILDINQ DEPARTMENT •�EATING SVS7EM: . rnc V _ <br />zse-ee� o <br />O DEMOLITION C7 COMBINATION <br />___.._ _ .••,.•���-wrvwn�cLowoR <br />lOT K� <br />Or �. <br />�,� ����� <br />�Mca Tpc i.o. nuwin <br />FOR OFFICE USE ONLY:- <br />i � �� <br />•, �. , <br />� <br />L� BUILOING <br />ELECTRIC `,J <br />CAL <br />Cp1T�CT PER$p� µD PIIpNE ryp. <br />❑ PLUMBING <br />�— <br />�3 �3��— <br />O SIGN <br />i HEREBY CERTIFY THAT I HAyE READ AND EXAMINEO TNIS <br />APPLICATiON AND KNOW 7HE SAME TO BE TRUE AND CORRECT, ALL <br />PROVISIONS OF tAWS AND OHDINANCES CiOVERNINO TNIS TYpE OF <br />cor�es� WORK W4L BE COMPLETED WITN WHETHER SPECIFIED HEREIN OR <br />�_ NOT. THE GRANTINO OF A PERMIT DOES NOT PqESUME TO OIVE <br />AUTHORITV TO yIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHEF STqTE OR LOCAL LAW REOULATINQ CONSTRUCTION Oq 7HE <br />PERFORMANCE OF CONS7qUCTION. TNAT I AM AUiF10RIZE0 BY TNE <br />OWNER OF THIS aROPERTY TO PERFORM THE WORK FOR WHICN <br />APPLICATION iS MADE AND I COMP�V WITH THE BTATE <br />CONT�AETORS�q�W 1 B27 RCW AND 29g,Ypp yy�p, <br />E%HAUSTFAN <br />A� <br />f <br />UY(ZON[ � I /�/j i� L/ I " I wEGEIFTNO. <br />IOT�REh �f ) / <br />DATE <br />^ VES ' Np --- <br />^cu..rc. roaownow:u,�,y Bu40iNG <br />�aour <br />PLUMBING <br />�.9EMENT <br />❑ YES O NO MECMANICAL <br />f�O��TIMAlUT10N � ADDITIONALPUNCHECK <br />OTHEH <br />STATE BUilOING $URLHARGE ' <br />CITY OF EVERETT pVBLIC WOFKS <br />LOCAL SALES <br />TAX CODE IS 3105 roT�� <br />a <br />0 <br />