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APPLICATI�1 FOR CONSTRUC7�N PERMIT� <br />CITV OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 • 257•BB70 <br />{�MECMANICAL ❑ PLUMBING ❑ 316N <br />f7 DEMOLRION ❑ COMBINATION ❑ BUILDING <br />PROJECT ADDRESS , p a <br />iGU i���mOr[ �J�✓O� �W/G'�t ✓/� Z <br />wmur ......-.......... <br />E >t fjZCi 4L —2�"iL-68� <br />�1%. /I �Rw�l �4✓i� ZO OL�M . I✓ nrr 2A ��E <br />i[NWi 4�M1�OME55 <br />1PCN11fClOqCE54NLR 4�Il�DME55 C11V 2m A�rt <br />GCMP�LCONiR�CtOR MM�COaC55 <br />LIiV ZT AMrt Si�1ElICENSE• <br />o T N,tr oC dn. i0Z � w ..�.•� 9SU4G aZ;-3�'S-�+'cv JAYe1/OL�O44CN <br />��T� l� ��p� SL�frlKENSE� <br />MCC �HiC�ICONiR�LiCR M�M1�Cq1C5$ <br />��Jr jp p�pK $iI.IEL�CENSf• <br />RV4BIIqCONiP�GIpR M�LL�CC�[55 <br />LOi ___ BIOCM � <br />r�acci *e� � o Hwe[a <br />oo�0 6zoo 00 �i80z <br />�rv�c u^1NxnOI,NIENCCR./.OIX�ESS.iELC�NM1[bVY9EN <br />FOR OFFICE USE ONLY: <br />ppOM SE1B�Cx A��a` <br />USEIOME LOiI.P <br />NE1G111liVll�iqN <br />a <br />ra m owswnc <br />UNI15 <br />SIOE SE19u.R <br />V�UNi SiiE <br />❑VCS fINO <br />x e�oni i <br />0�5[MCNi <br />:�,res ;: No <br />HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br />conirti v�rsoN �vo nw.¢ i+o <br />I HEREBY CERTIFY 'iHAT I HA\'E REAO AND E%AMINED TMIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CARRECT. ALL <br />PROVISIONS OF UWS AN� ORDINANCES GOVERNING THIS TYPE OF <br />WORN WILI BE COMPLIED WITH WMETHER SPELIFIED HEREIN OR <br />NOT. TME GRANTING OF A PERMIT DOES NOT PPESUME TO GIVE <br />AUTHORITY 70 VIOUTE OR CPNCEL THE PROVISION OF 4NY <br />OTHER STATE OR LOCAL UW RE�ULAT�NG CONSTPVCTION OR 7HE <br />PEFFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICM <br />RPPLICATION IS MADE AN� I COMPLV WIiH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAO. <br />����1��� Oi/ 24/7vo � <br />s�cu.ivac/ o"*E <br />DAYN/VNOU4/5_H <br />n�v euswcss i¢visc w <br />RANLMCMNVY9ER «E <br />FEES <br />ow�D� <br />%UMBM(i <br />uct��N�+� <br />•r,ortaNu ruri cvECK <br />pnRn <br />so*c emmmc s�ncru+aE <br />CITY OF EVERETT �w�� �'"s <br />LOCIIL SALES <br />TAI( CODE IS 0105 TOT�L <br />S <br />RECEivitA <br />